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Antibiotic prescription practices, consumption and bacterial resistance in a cross section of Swedish intensive care units

Walther, Sten M. ; Erlandsson, M. LU ; Burman, L. G. ; Cars, O. ; Gill, H. ; Hoffman, M. ; Isaksson, B. ; Kahlmeter, G. ; Lindgren, S. and Nilsson, L. , et al. (2002) In Acta Anaesthesiologica Scandinavica 46(9). p.1075-1081
Abstract

Background: The purpose of this work was to study usage of antibiotics, its possible determinants, and patterns of bacterial resistance in Swedish intensive care units (ICUs). Methods: Prospectively collected data on species and antibiotic resistance of clinical isolates and antibiotic consumption specific to each ICU in 1999 were analyzed together with answers to a questionnaire. Antibiotic usage was measured as defined daily doses per 1000 occupied bed days (DDD1000). Results: Data were obtained for 38 ICUs providing services to a population of approximately 6 million. The median antibiotic consumption was 1257 DDD1000 (range 584-2415) and correlated with the length of stay but not with the illness severity score... (More)

Background: The purpose of this work was to study usage of antibiotics, its possible determinants, and patterns of bacterial resistance in Swedish intensive care units (ICUs). Methods: Prospectively collected data on species and antibiotic resistance of clinical isolates and antibiotic consumption specific to each ICU in 1999 were analyzed together with answers to a questionnaire. Antibiotic usage was measured as defined daily doses per 1000 occupied bed days (DDD1000). Results: Data were obtained for 38 ICUs providing services to a population of approximately 6 million. The median antibiotic consumption was 1257 DDD1000 (range 584-2415) and correlated with the length of stay but not with the illness severity score or the ICU category. Antibiotic consumption was higher in the ICUs lacking bedside devices for hand disinfection (2193 vs. 1214 DDD1000, p = 0.05). In the ICUs with a specialist in infectious diseases responsible for antibiotic treatment the consumption pattern was different only for use of glycopeptides (58% lower usage than in other ICUs: 26 vs. 11 DDD1000, P=0.02). Only 21% of the ICUs had a written guideline on the use of antibiotics, 57% received information on antibiotic usage at least every 3 months and 22% received aggregated resistance data annually. Clinically significant antimicrobial resistance was found among Enterbacter spp. to cephalosporins and among Enterococcus spp. to ampicillin. Conclusions: Availability of hand disinfection equipment at each bed and a specialist in infectious diseases responsible for antibiotic treatment were factors that correlated with lower antibiotic consumption in Swedish ICUs, whereas patient-related factors were not associated with antibiotic usage.

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type
Contribution to journal
publication status
published
subject
keywords
Anti-infective agents, Critical care, Cross infection, Multiple drug resistance
in
Acta Anaesthesiologica Scandinavica
volume
46
issue
9
pages
1075 - 1081
publisher
Wiley-Blackwell
external identifiers
  • pmid:12366501
  • scopus:18544365847
ISSN
0001-5172
DOI
10.1034/j.1399-6576.2002.460904.x
language
English
LU publication?
no
id
0b6064fa-5854-4891-979a-8152cac43d84
date added to LUP
2020-04-16 11:24:55
date last changed
2021-01-06 06:57:27
@article{0b6064fa-5854-4891-979a-8152cac43d84,
  abstract     = {<p>Background: The purpose of this work was to study usage of antibiotics, its possible determinants, and patterns of bacterial resistance in Swedish intensive care units (ICUs). Methods: Prospectively collected data on species and antibiotic resistance of clinical isolates and antibiotic consumption specific to each ICU in 1999 were analyzed together with answers to a questionnaire. Antibiotic usage was measured as defined daily doses per 1000 occupied bed days (DDD<sub>1000</sub>). Results: Data were obtained for 38 ICUs providing services to a population of approximately 6 million. The median antibiotic consumption was 1257 DDD<sub>1000</sub> (range 584-2415) and correlated with the length of stay but not with the illness severity score or the ICU category. Antibiotic consumption was higher in the ICUs lacking bedside devices for hand disinfection (2193 vs. 1214 DDD<sub>1000</sub>, p = 0.05). In the ICUs with a specialist in infectious diseases responsible for antibiotic treatment the consumption pattern was different only for use of glycopeptides (58% lower usage than in other ICUs: 26 vs. 11 DDD<sub>1000</sub>, P=0.02). Only 21% of the ICUs had a written guideline on the use of antibiotics, 57% received information on antibiotic usage at least every 3 months and 22% received aggregated resistance data annually. Clinically significant antimicrobial resistance was found among Enterbacter spp. to cephalosporins and among Enterococcus spp. to ampicillin. Conclusions: Availability of hand disinfection equipment at each bed and a specialist in infectious diseases responsible for antibiotic treatment were factors that correlated with lower antibiotic consumption in Swedish ICUs, whereas patient-related factors were not associated with antibiotic usage.</p>},
  author       = {Walther, Sten M. and Erlandsson, M. and Burman, L. G. and Cars, O. and Gill, H. and Hoffman, M. and Isaksson, B. and Kahlmeter, G. and Lindgren, S. and Nilsson, L. and Olsson-Liljequist, B. and Hanberger, H. and Struwe, Johan and Häggqvist, Jan and Hulting, Johan and Stiernström, Hans and Löwdin, Elisabeth and Sundin, Carl Gustaf and Hjorth, Veronika and Riese, Ulf and Engdahl, Olle and Vegfors, Magnus and Theodorsson, Annette and Lindberget, Ola and Eriksson, Sverker and Lindquist, Jan and Nordlund, Peter and Sören, Lars and Jarnheimer, Peråke and Berkius, Johan and Eklund, Per Olof and Brodersen, Keld and Eden, Tony and Hallgärde, Åsa and Hacklou, Janet and Petersen, Per and Lundqvist, Anders and Anderzon, Göran and Wahl, Martin and Öberg, Sven and Lorentzen, Per and Elowson, Sören and Nyström, Robert and Ahlqvist, Thomas and Nydahl, Anders and Fredlund, Hans and Vig, Ivan and Riesenfeld-Örn, Inger and Magnusson, Bo},
  issn         = {0001-5172},
  language     = {eng},
  number       = {9},
  pages        = {1075--1081},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Antibiotic prescription practices, consumption and bacterial resistance in a cross section of Swedish intensive care units},
  url          = {http://dx.doi.org/10.1034/j.1399-6576.2002.460904.x},
  doi          = {10.1034/j.1399-6576.2002.460904.x},
  volume       = {46},
  year         = {2002},
}