Use of 27 parenteral antimicrobial agents in north of France hospitals

Abstract

Background: Little data are available on antibiotic (AB) use in French hospitals.

Methods: 1995-2001 annual data on WHO defined daily doses (DDD) and hospitalization days (HD) were collected from volunteer hospitals. Twenty-three AB (amikacin, aztreonam, cefepime, cefotaxime, cefpirome, ceftazidime, ceftriaxone, ciprofloxacin, fosfomycin, fusidic acid, levofloxacin, imipenem, isepamicin, ofloxacin, pefloxacin, piperacillin, piperacillin/tazobactam, quinupristin/dalfopristin, sulbactam, teicoplanin, ticarcillin, ticarcillin-clavulanic acid, vancomycin) and four antifungals (amphotericin B lipid formulations, caspofungin, and fluconazole) were surveyed. Antimicrobial use was expressed as the number of DDD per 1000 HD.

Results: Fifty-eight hospitals participated in the 2001 study. AB consumption was higher in hospitals with > 400 acute care beds (214.8 +/- 116 DDD/HD) than in 200-400 beds hospitals (134.2 +/- 39 DDD/HD) or < 200 beds hospitals (104.3 +/- 74 DDD/HD) P = 0.0005. Wide variations in AB choice and volumes were observed among similar sized hospital. Fifteen hospitals, representing one third of the region's acute care beds, provided complete 7-year data. The use of antibacterials increased 23% from 119.9 to 147.2 DDD per 1000 HD. Most of this increase was due to fluoroquinolones (plus 72%; 17.8 vs. 30.6, P = 0.0068), ceftriaxone (plus 90%; 14.4 vs. 27.4; P < 0.0001), and cefepime (plus 264%; 3.4 vs. 12.2%, P = 0.028). The only decreasing class was aminoglycosides (minus 48%; 27.7 vs. 14.5; P = 0.003).

Conclusions: This data confirms the high level of AB consumption in French hospitals.