Repeated nationwide point-prevalence surveys of antimicrobial use in Swedish hospitals: data for actions 2003-2010

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 21; no. 25; p. 1
• Main Authors: Skoog, Gunilla, Struwe, Johan, Cars, Otto, Hanberger, Håkan, Odenholt, Inga, Prag, Mårten, Skärlund, Katarina, Ulleryd, Peter, Erntell, Mats
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 23.06.2016
• Subjects: 3-year survey; acquired infections; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; antibiotic use; Antimicrobial agents; Bacterial Infections - drug therapy; Bacterial Infections - epidemiology; Child; Child, Preschool; Clinical Medicine; Community-Acquired Infections - drug therapy; Community-Acquired Infections - epidemiology; Compliance; countries; Cross Infection - drug therapy; Cross Infection - epidemiology; Drug Prescriptions - standards; Drug Prescriptions - statistics & numerical data; Drug resistance; Epidemiology; european; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Guideline Adherence - statistics & numerical data; guidelines; Health Sciences; Hospitalization - statistics & numerical data; Hospitals; Humans; Hälsovetenskap; implementation; Infant; Infant, Newborn; Infectious Diseases; Infectious Medicine; Infektionsmedicin; Klinisk medicin; Male; Medical and Health Sciences; Medical treatment; medical wards; Medicin och hälsovetenskap; Middle Aged; Nosocomial infections; oral antibiotics; Practice Guidelines as Topic; Prevalence; Public Health, Global Health, Social Medicine and Epidemiology; region; Risk Factors; Sweden - epidemiology; university hospitals; Young Adult; Sweden; antibiotic use; antimicrobial stewardship; surgical prophylaxis; community-acquired infection; Strama; healthcare-associated infections
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES.2016.21.25.30264

This study sought to analyse antimicrobial pressure, indications for treatment, and compliance with treatment recommendations and to identify possible problem areas where inappropriate use could be improved through interventions by the network of the local Swedish Strategic Programme Against Antibiotic Resistance (Strama) groups. Five point-prevalence surveys were performed in between 49 and 72 participating hospitals from 2003 to 2010. Treatments were recorded for 19 predefined diagnosis groups and whether they were for community-acquired infection, hospital-acquired infection, or prophylaxis. Approximately one-third of inpatients were treated with antimicrobials. Compliance with guidelines for treatment of community-acquired pneumonia with narrow-spectrum penicillin was 17.0% during baseline 2003-2004, and significantly improved to 24.2% in 2010. Corresponding figures for quinolone use in uncomplicated cystitis in women were 28.5% in 2003-2004, and significantly improved, decreasing to 15.3% in 2010. The length of surgical prophylaxis improved significantly when data for a single dose and 1 day were combined, from 56.3% in 2003-2004 to 66.6% in 2010. Improved compliance was possibly the effect of active local feedback, repeated surveys, and increasing awareness of antimicrobial resistance. Strama groups are important for successful local implementation of antimicrobial stewardship programs in Sweden.