Impact of amoxicillin and oral amoxicillin-clavulanic acid defined daily doses on consumption indicators

Abstract

Objective: To measure the impact of the differences between recommended daily average maintenance doses and defined daily doses on antimicrobial consumption indicators (amoxicillin+amoxicillin-clavulanic acid).

Material and methods: We calculated the impact of the antibacterial agent switch or de-escalation and reviewed the consumption indicators of our French hospital with defined daily doses (DDD) of 3g. We also applied these DDDs to French and European community setting indicators in private practice.

Results: We observed a modification in trend consumption indicators over a 10-year period: indicator stability for our hospital (-0.32% versus +5.45%), decrease for French community indicators (-9.9% versus +6.7%). The recalculated 2015 data for European community indicators showed France as the 9th largest European consumer (versus 4th position before).

Conclusion: DDDs must be modified to have appropriate indicators to evaluate antimicrobial stewardship programs and to penalize prescriptions favoring the emergence of resistant pathogens.

Keywords: Antibacterial agents; Antibiotic stewardship; Antibiotiques; Bon usage des antibiotiques; Defined daily doses; Dose définie journalière.