Use of antibiotics in hospitals in south-western France

Rogues, Anne-Marie; Placet-Thomazeau, B.; Parneix, Pierre; Vincent, I.C.; Mc, Ploy; Marty, N.; Merillou, B.; Labadie, Jean-Claude; Gachie, J.P.

doi:10.1016/j.jhin.2004.07.019

Cited by 40 publications

(30 citation statements)

References 17 publications

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“…The weighted means were 112.3 DDD/100 (73.6 RDD/100) in the ICU area versus 47.1 DDD/100 (29.6 RDD/100) in the non-ICU wards, respectively. These values are similar to those calculated for a sample of hospitals in the south-western part of the country [9], and also similar to results reported for France, Sweden, Norway, Denmark, and the Netherlands [11][12][13][14][15].…”

Section: Overall Hospital Antibiotic Use Density In 2003supporting

confidence: 90%

Is There Significant Regional Variation in Hospital Antibiotic Consumption in Germany?

2006

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Section: Overall Hospital Antibiotic Use Density In 2003supporting

confidence: 90%

Is There Significant Regional Variation in Hospital Antibiotic Consumption in Germany?

2006

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“…The opposite problem occurs in evaluating antibiotic use in children who usually take antibiotic dosages lower than adults: the DDD definition does not account for dose adaptation in childhood, and this is a limitation of the DDD methodology. 16 In our study, surgical units used more antibiotics than medical units. Antibiotic prophylaxis in surgery is one of the matters of discussion about hospital use of antimicrobial agents, since surgical procedures are often associated with unnecessary prescription of antibiotics.…”

Section: Discussionmentioning

confidence: 68%

A 3 year survey on the use of antibacterial agents in five Italian hospitals

Vaccheri

Silvani

Bersaglia

et al. 2008

Journal of Antimicrobial Chemotherapy

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Background: Misuse of antimicrobial agents in hospitals may cause the emergence of resistant microorganisms, as well as increased costs and unnecessary exposure of patients to drugs. We investigated the pattern of antibiotic consumption in 2002 -04 in a sample of Italian hospitals, and compared this with antibiotic consumption data in primary healthcare in the Emilia-Romagna region. Methods:The study was carried out in five hospitals of the Emilia-Romagna region and 2002-04 drug use data were obtained from the pharmacy services. Data were analysed by clinical areas and single wards and were expressed by ATC classification and defined daily doses (DDD)/100 bed days. Prescription data of antibacterials in primary care in the same period were also analysed.Results: Antibiotic consumption increased by 18% in the 3 year period. Combinations of penicillins and b-lactamase inhibitors were the most used drugs, followed by fluoroquinolones and thirdgeneration cephalosporins. Penicillins plus b-lactamase inhibitors increased in all the clinical areas by over 40%, and fluoroquinolones sharply increased in medical units (129%). Third-generation cephalosporins remained fairly stable in paediatrics and surgery, but increased in medicine (118%). Glycopeptides accounted for 4.3% of total antibiotic consumption with a peak of 10% in intensive care units. Antibacterial prescription in primary care showed a pattern similar to that of hospitals. Conclusions:We found a considerable increase in antibiotic use over time and a marked preference for wide-spectrum antibiotics such as penicillins plus b-lactamase inhibitors, fluoroquinolones and third-generation cephalosporins; thus raising concern about appropriate use. These results could represent the basis for educational initiatives aimed at rationalizing the use of antibiotics in hospitals.

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“…As mentioned above, fluoroquinolones, especially ciprofloxacin, were associated with the highest relative risk for CDAD [8]. At CHUS in 2003-2004, fluoroquinolones contributed to 28% of the total AUR measured using the DDD (and 25% of that measured using the PDD), compared with 3% in France [29], 6% in Denmark [32], 10% in The Netherlands [31], and 15%-22% in Germany [35]. Thus, overuse of fluoroquinolones may have contributed to the magnitude of the n-CDAD epidemic.…”

Section: Discussionmentioning

confidence: 86%

“…Our data do not suggest that the staggering epidemic of CDAD in our hospital was precipitated by an aberrant overall level of antimicrobial use. Many researchers have measured the overall use of antibiotics among inpatients, dividing amounts of drugs dispensed out of hospital pharmacies by the DDD and relating this to the number of patient-days of hospitalization, and they have obtained remarkably similar results: the AUR was found to be 0.400 in Switzerland [28], 0.402 in France [29], 0.425-0.547 in The Netherlands [30,31], 0.448 in Denmark [32], 0.477 in Sweden [33], 0.490 in German regional hospitals, and 0.601-0.793 in German university hospitals [34,35]. This compares closely to our AUR estimate calculated using the same DDD: 0.465 in [2003][2004].…”

Section: Discussionmentioning

confidence: 99%

Impact of a Reduction in the Use of High-Risk Antibiotics on the Course of an Epidemic of Clostridium difficile-Associated Disease Caused by the Hypervirulent NAP1/027 Strain

Valiquette

Cossette

Garant

et al. 2007

Clinical Infectious Diseases

298

171

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A series of measures were implemented, in a secondary/tertiary-care hospital in Quebec, to control an epidemic of nosocomial Clostridium difficile-associated disease (n-CDAD) caused by a virulent strain; these measures included the development of a nonrestrictive antimicrobial stewardship program. Interrupted time-series analysis was used to evaluate the impact of these measures on n-CDAD incidence. ), but implementation of the antimicrobial stewardship program was followed by P p .63 a marked reduction in incidence (). This suggests that nonrestrictive measures to optimize antibiotic P p .007 usage can yield exceptional results when physicians are motivated and that such measures should be a mandatory component of n-CDAD control. The inefficacy of infection control measures targeting transmission through hospital personnel might be a result of their implementation late in the epidemic, when the environment was heavily contaminated with spores.

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Use of antibiotics in hospitals in south-western France

Cited by 40 publications

References 17 publications

Is There Significant Regional Variation in Hospital Antibiotic Consumption in Germany?

Is There Significant Regional Variation in Hospital Antibiotic Consumption in Germany?

A 3 year survey on the use of antibacterial agents in five Italian hospitals

Impact of a Reduction in the Use of High-Risk Antibiotics on the Course of an Epidemic of Clostridium difficile-Associated Disease Caused by the Hypervirulent NAP1/027 Strain

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