Use of broad spectrum antibiotics in six non-university Swiss hospitals.

Détails

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Etat: Serval
Version: Final published version
ID Serval
serval:BIB_92CD5EFAA95F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Use of broad spectrum antibiotics in six non-university Swiss hospitals.
Périodique
Swiss medical weekly
Auteur(s)
von Gunten V., Reymond J.P., Troillet N.
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
28/07/2001
Peer-reviewed
Oui
Volume
131
Numéro
29-30
Pages
438-441
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Broad-spectrum antibiotics (BSAs) are costly and prone to misuse. Their use is associated with the emergence of resistant bacteria. This article describes the first step of an interhospital programme for the appropriate use of BSAs.
BSAs were defined as the i.v. antibiotics present in the formulary shared by the six participating institutions and considered to be antipseudomonal agents (i.e. cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, piperacillin/tazobactam) plus trovafloxacin. Annual utilisation rates and interhospital comparisons were provided to each institution using the "defined daily dosages" (DDDs) of the World Health Organization.
From 1997 to 1999, the overall utilisation rate of BSAs increased from 20.6 treatment days (TD)/1000 patient days (PD) to 36.5 TD/1000 PD. Significant interhospital differences were detected (range: 12.1 TD/1000 PD in 1997-66.5 TD/1000 PD in 1999). The highest relative risk for treatment with any BSA for each individual hospital in comparison to the others was determined for 1999 (RR = 2.92; 95% confidence interval: 2.81-3.04). In 1999, the most frequently used BSAs were cefepime, imipenem, and piperacillin/tazobactam respectively.
Although this programme does not provide information on the indications for using BSAs in various hospitals, it helps to identify those institutions where the selection pressure for resistant bacteria is highest, and that could particularly benefit from specific interventions aiming at decreasing this pressure and controlling drug expenditure. Moreover, the feedback of utilisation rates and interhospital comparisons to the prescribing physicians might have a positive impact on BSA use.

Mots-clé
Anti-Bacterial Agents/administration & dosage, Anti-Bacterial Agents/therapeutic use, Bacterial Infections/drug therapy, Drug Utilization/economics, Hospitals, Humans, Switzerland
Pubmed
Web of science
Création de la notice
28/12/2013 18:34
Dernière modification de la notice
03/03/2018 19:33
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