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Systematic Review of Antibiotic Consumption in Acute Care Hospitals.
Clin Microbiol Infect. 2016 Feb 16;
Authors: Bitterman R, Hussein K, Leibovici L, Carmeli Y, Paul M
Abstract
Antibiotic consumption (AbC) is an easily quantifiable performance measure in hospitals and might be used for monitoring. We conducted a review of published studies and online surveillance reports reporting on AbC in acute care hospitals between the years 1997 and 2013. A pooled estimate of AbC was calculated using a random effects meta-analysis of rates with 95% confidence intervals. Heterogeneity was assessed through subgroup analysis and meta-regression. Eighty studies, comprising 3130 hospitals, met inclusion criteria. The pooled rate of hospital-wide consumption was 586 (540-632) defined daily doses (DDD)/1000 hospital days (HD) for all antibacterials. However, consumption rates were highly heterogeneous. Antibacterial consumption was highest in intensive care units, 1563 DDD/1000HD (1472-1653). Hospital-wide antibacterial consumption was higher in Western Europe, and medium-sized, private and university-affiliated hospitals. The methods of data collection were significantly associated with consumption rates, including data sources, dispensing vs. purchase vs. usage data, counting admission and discharge days and inclusion of low-consumption departments. Heterogeneity remained in all subgroup analyses. Major heterogeneity currently precludes defining acceptable AbC ranges in acute care hospitals. Guidelines on AbC reporting that will account for case-mix and a minimal set hospital characteristics, recommending standardized methods for monitoring and reporting, are needed.
PMID: 26899826 [PubMed - as supplied by publisher]