Marked Differences in Antibiotic Use and Resistance Between University Hospitals in Vilnius, Lithuania, and Huddinge, Sweden

Abstract

Antibiotic use and antimicrobial resistance was compared between Vilnius and Huddinge University hospitals. Drug use data were expressed in number of defined daily doses/100 bed-days; antimicrobial resistance were given as percentages of resistant isolates. Thirty-five and 48 different antibiotic drugs were used in Vilnius and Huddinge, respectively. The overall consumption of antibiotics was 15 DDD/100 bed-days in Vilnius and 43 DDD/100 bed-days in Huddinge. Benzylpenicillin, ampicillin, and aminoglycosides were the major antibiotics in Vilnius; beta-lactamase-resistant penicillins, cefalosporins, and quinolones in Huddinge. In Vilnius, gentamicin made up one-quarter of the use. Staphylococcus aureus and Gram-negative isolates from wounds and blood were more resistant to gentamicin in Vilnius. S. aureus was more often methicillin resistant in Vilnius than in Huddinge. There was no S. aureus-resistant to vancomycin in either hospital. The vancomycin-resistant enterococci made up from 4% to 10% in Vilnius hospital, but they were not detected in Huddinge hospital (0%). The majority of Streptococcus pneumoniae isolates were sensitive to benzylpenicillin in both hospitals. The higher resistance of microorganisms to some antibiotics in Vilnius may be explained by heavy use of few antibiotics. Lower level of hygiene procedures, sampling bias, and other methodological issues may also have contributed. Guidelines for antibiotic use and hygienic procedures are now under development in Vilnius.

Antimicrobial susceptibility and molecular analysis of Enterococcus faecalis originating from endodontic infections in Finland and Lithuania

“…Notably, no vancomycin‐resistant enterococci were found among the Lithuanian endodontic isolates. A vancomycin‐resistant enterococci prevalence of 4–10%, depending on isolation site, among nosocomial enterococci (60% were E. faecalis ) has been reported in Vilnius University Hospital (Lithuania) (11), but direct comparison with this data set is not possible due to the size of the study sample, differences in the patient group types, exposure to antibiotics and the possibility that the above study may have included an outbreak.…”

“…The prevalence of antibiotic‐resistant strains is associated with selective pressure by antibiotics (10). We aimed to study the antibiotic susceptibility of isolates of E. faecalis originating from endodontic infections in two different countries, Finland and Lithuania, as these differ both in their antibiotic guidelines and in their treatment of endodontic infections, calcium hydroxide being commonly used as an endodontic dressing in Finland, unlike in Lithuania (4, 9, 11, 19, 29, 37). We further aimed to compare their relatedness by pulsed‐field gel‐electrophoresis (PFGE) and to investigate the observed sensitivity to quinupristin‐dalfopristin of some oral isolates of E. faecalis .…”

Analysis of antibiotic utilization and bacterial resistance changes in a surgical clinic of Clinical Centre, Nis

“…Tertiary care hospitals are a potential source for development and spread of bacterial resistance 1–5 . Antibiotics are the most frequently used medications in Serbian surgical inpatients.…”

“…Antibiotic therapy is an important adjunct to surgical or radiological guided procedures designed to gain control of the infected focus and, for this reason, susceptibility patterns of aetiological agents of those infections are relevant 6 . Many studies have demonstrated geographical differences in antibiotic activity, as well as differences between institutions or even wards within institutions 1,2,5,6 . Factors that promote the emergence of resistance include frequent and prolonged use of broad‐spectrum antimicrobial agents, and more frequent use of invasive devices and procedures 7–9 …”

Trends in Antibiotic Use at a University Hospital: Defined or Prescribed Daily Doses? Patient Days or Admissions as Denominator?

“…In other studies hospital pharmacy databases or computerized inpatient drug prescription records were used to indicate the "tonnage" of specific drugs or drug expenditures per time period or per beds, bed days or admissions for a specific time period. An increasing number of studies have used quantitation by defined daily doses (DDD) as recommended by the World Health Organization (WHO) collaborating Center for Drug Statistics Methodology (in the Anatomical Therapeutic Chemical [ATC]/WHO index) related to 100 occupied bed days (or patient days) as denominator [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”