POINT PREVALENCE STUDIES (PPS) OF ANTIMICROBIAL USE IN SWEDISH HOSPITALS, 2003 AND 2004

1. POINT PREVALENCE STUDIES (PPS) OF ANTIMICROBIAL USE IN SWEDISH HOSPITALS, 2003 AND 2004 Abstract Background and Objective: The objective of the study was to introduce a nation wide survey system for frequent assessment of the use of antimicrobial agents in relation to diagnose. Design: Two PPS with one personal visit to each department were performed within a two-week period in November 2003 and 2004. The protocol was designed to present demographic data as well as the amounts and indications for antimicrobial agents against bacteria and fungi. Treatments were recorded in relation to diagnose and therapy reason (community acquired (CAI) or hospital acquired infection (HAI)). 19 pre-defined diagnosis groups were used. Prophylactic use was recorded in relation to prescribed doses. DDDs were calculated according to the WHO standard. A web-based reporting system was used to collect the data. Setting: Swedish hospitals, 31 different specialities. Main outcome measures: Antimicrobial use, in DDDs, in relation to diagnose and therapy reason. Results: The departments participating in both studies included 10 255 and 10 305 admitted patients respectively. Correspondingly 31% and 32% of the admitted patients were treated with antimicrobials. Distribution of women/men and adults/children were similar both years. The numbers of therapies were 3377 (54% CAI, 27% HAI, 19% prophylaxis) and 3523 (52% CAI, 28% HAI, 20% prophylaxis) respectively. A large fraction of women with cystitis were treated with fluoroquinolones (20% resp. 24%). The most common indication for cephalosporins (DDD) was community acquired pulmonary infections. Duration of peri-operative prophylaxis was more than 24 hours in about 40% of the cases. Conclusions: Demographic data from the two study periods were congruent. Analysis of antimicrobial use in relation to diagnose and therapy reason is an important tool to identify problem areas. Although the PPS method is time consuming, it was successfully introduced resulting in one of the largest surveys in Europe of antimicrobial hospital treatment. Skoog G, Cars O, Skärlund K, Elowson S, Hanberger H, Odenholt I, Prag M, Struwe J, Torell E, Ulleryd P, Erntell M. STRAMA, Swedish Institute for Infectious Disease Control, S-171 82 Solna, Sweden Diagnose groups Central nervous system Ophthalmic infections Mouth and throat Upper respiratory tract Bronchitis Pulmonary infections Cardiovascular system Upper gastrointestinal tract Lower gastrointestinal tract Infectious gastrointestinal diseases Liver/bile duct/pancreas/spleen Skin and soft tissue Bone and joint Lower urinary tract infection Upper urinary tract infection Genital infections Septicaemia, primary Un-specified indication, fever Indication unclear