Antibiotika-Anwendung 2012/13 in 109 deutschen Akutkrankenhäusern

Abstract

Prescribing of antibiotics on almost every second day of hospitalization was extensive and highly variable, and the frequent use of cephalosporins is noteworthy. It is possible that the development of resistance and the rate of Clostridium difficile infection is associated with the diverse antibiotic use intensity and preferences for prescribing of cephalosporins and fluoroquinolones. Continuous antibiotic use surveillance and evaluation of prescribing patterns in acute care with feedback and benchmarking will help optimizing antibiotic use and better assessing strategies to minimize resistance and Clostridium difficile infection, and eventually improve patient safety.

S2k-Leitlinie: Diagnostik bei Verdacht auf eine Betalaktamantibiotika-Überempfindlichkeit

“…Diese problematische Entwicklung wird durch die in den letzten Jahren signi kant angestiegene Verordnungsdichte von Cephalosporinen unterstrichen [10,17]. Als ein Grund für die Verordnung von Oralcephalosporinen anstelle von Penicillinderivaten werden Überemp ndlichkeiten angeführt [10].…”

Guideline on diagnostic procedures for suspected hypersensitivity to beta-lactam antibiotics

“…This problematic development is underscored by the significant rise in prescribing rates for cephalosporins in recent years [10,17]. A history of hypersensitivity is given as the reason for prescribing oral cephalosporins instead of penicillin derivatives [10].…”

Management of a cluster of Clostridium difficile infections among patients with osteoarticular infections

“…The DDD of benzylpenicillin is 3.6 g. Treatment of serious infections, however, generally requires a dose of 12 g or even higher. Thus calculating DDD while using much higher therapeutic doses results in an overestimation of the prescribed doses [ 28 ]. If correcting this by using recommended daily doses (RDD) [ 28 ] for the calculation of antibiotic consumption the antibiotic consumption before intervention was 99.0 RDD/100 hospital bed days and after intervention 86.1 RDD/100 hospital bed days, indicating that the number of prescribed doses on the septic ward was reduced roughly 13%.…”

“…Thus calculating DDD while using much higher therapeutic doses results in an overestimation of the prescribed doses [ 28 ]. If correcting this by using recommended daily doses (RDD) [ 28 ] for the calculation of antibiotic consumption the antibiotic consumption before intervention was 99.0 RDD/100 hospital bed days and after intervention 86.1 RDD/100 hospital bed days, indicating that the number of prescribed doses on the septic ward was reduced roughly 13%. Total antibiotic consumption on the septic ward, however, remained significantly above the available national benchmark data for surgical departments other than general surgery (75% quantile 56 RDD/100 hospital bed days) [ 28 , 29 ].…”