A nationwide evaluation of antibiotics consumption in Swedish intensive care units
(2022) In Infectious Diseases 54(10). p.713-721- Abstract
Background: Around 70% of all ICU patients are treated with antibiotics whereas up to 30% are suggested as unnecessary. Measuring antibiotic consumption is a prerequisite to improving its use and the purpose of the present investigation was to explore the use of antibiotics in Swedish ICUs. Material and methods: Daily Defined Doses (DDDs) of antimicrobials delivered to Swedish ICUs, 2016–2018, were retrieved from Swedish pharmacies. From the Swedish Intensive Care Registry, we extracted data on a number of patient admissions, occupied bed days and Simplified Acute Physiology Score (SAPS)3. Results: There was a similar annual rate of total DDDs per admission of 3.7, 3.5, 3.8 and total DDDs per 100 occupied bed days of 111, 111, and 115... (More)
Background: Around 70% of all ICU patients are treated with antibiotics whereas up to 30% are suggested as unnecessary. Measuring antibiotic consumption is a prerequisite to improving its use and the purpose of the present investigation was to explore the use of antibiotics in Swedish ICUs. Material and methods: Daily Defined Doses (DDDs) of antimicrobials delivered to Swedish ICUs, 2016–2018, were retrieved from Swedish pharmacies. From the Swedish Intensive Care Registry, we extracted data on a number of patient admissions, occupied bed days and Simplified Acute Physiology Score (SAPS)3. Results: There was a similar annual rate of total DDDs per admission of 3.7, 3.5, 3.8 and total DDDs per 100 occupied bed days of 111, 111, and 115 but with an approximately 6-fold difference of DDDs per occupied bed days (61–366) between the ICUs. The most frequently used antibiotics were isoxazolyl penicillins (J01CF), penicillins with betalactamase-inhibitors, mainly piperacillin/tazobactam (J01CR), 3rd and 4th generation cephalosporins (J01DD + DE) and carbapenems (J01DH). Together these four classes accounted for a median of 52% of all antibiotic use. The use of carbapenems had a moderate positive correlation with the mean SAPS3 score (r = 0.6, p =.01). The use of other broad-spectrum antibiotics showed no such correlation. Conclusion: Overall antibiotic use remained similar in Swedish ICUs during the years 2016–2018. Broad-spectrum antibiotics accounted for 50% of all DDDs but with a large inter-ICU variation which only partly can be explained by differences in patient case mix and microbial resistance. Presumably, it also reflects varying local prescribing practices.
(Less)
- author
- Sjövall, Fredrik LU ; Edström, Morgan ; Walther, Sten LU and Hanberger, Håkan
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Antibiotics, antimicrobial stewardship, antimicrobials, critical care, intensive care
- in
- Infectious Diseases
- volume
- 54
- issue
- 10
- pages
- 9 pages
- publisher
- Informa Healthcare
- external identifiers
-
- scopus:85135731066
- pmid:35638173
- ISSN
- 2374-4235
- DOI
- 10.1080/23744235.2022.2081717
- language
- English
- LU publication?
- yes
- id
- 2950cf8c-3ce5-4a6b-b68f-6bf8d7063d73
- date added to LUP
- 2022-09-19 11:12:44
- date last changed
- 2024-09-20 01:02:43
@article{2950cf8c-3ce5-4a6b-b68f-6bf8d7063d73, abstract = {{<p>Background: Around 70% of all ICU patients are treated with antibiotics whereas up to 30% are suggested as unnecessary. Measuring antibiotic consumption is a prerequisite to improving its use and the purpose of the present investigation was to explore the use of antibiotics in Swedish ICUs. Material and methods: Daily Defined Doses (DDDs) of antimicrobials delivered to Swedish ICUs, 2016–2018, were retrieved from Swedish pharmacies. From the Swedish Intensive Care Registry, we extracted data on a number of patient admissions, occupied bed days and Simplified Acute Physiology Score (SAPS)3. Results: There was a similar annual rate of total DDDs per admission of 3.7, 3.5, 3.8 and total DDDs per 100 occupied bed days of 111, 111, and 115 but with an approximately 6-fold difference of DDDs per occupied bed days (61–366) between the ICUs. The most frequently used antibiotics were isoxazolyl penicillins (J01CF), penicillins with betalactamase-inhibitors, mainly piperacillin/tazobactam (J01CR), 3rd and 4th generation cephalosporins (J01DD + DE) and carbapenems (J01DH). Together these four classes accounted for a median of 52% of all antibiotic use. The use of carbapenems had a moderate positive correlation with the mean SAPS3 score (r = 0.6, p =.01). The use of other broad-spectrum antibiotics showed no such correlation. Conclusion: Overall antibiotic use remained similar in Swedish ICUs during the years 2016–2018. Broad-spectrum antibiotics accounted for 50% of all DDDs but with a large inter-ICU variation which only partly can be explained by differences in patient case mix and microbial resistance. Presumably, it also reflects varying local prescribing practices.</p>}}, author = {{Sjövall, Fredrik and Edström, Morgan and Walther, Sten and Hanberger, Håkan}}, issn = {{2374-4235}}, keywords = {{Antibiotics; antimicrobial stewardship; antimicrobials; critical care; intensive care}}, language = {{eng}}, number = {{10}}, pages = {{713--721}}, publisher = {{Informa Healthcare}}, series = {{Infectious Diseases}}, title = {{A nationwide evaluation of antibiotics consumption in Swedish intensive care units}}, url = {{http://dx.doi.org/10.1080/23744235.2022.2081717}}, doi = {{10.1080/23744235.2022.2081717}}, volume = {{54}}, year = {{2022}}, }