An additional measure for quantifying antibiotic use in hospitals

Area of Science:

• Healthcare Management
• Infectious Disease Epidemiology
• Pharmacoeconomics

Background:

• Defined daily doses (DDD) per 100 patient days is a common metric for hospital antibiotic use.
• This metric is influenced by hospital resource indicators, potentially obscuring true antibiotic selection pressure.
• Additional metrics are needed for accurate interpretation of antibiotic use data.

Purpose of the Study:

• To evaluate the significance of different units of measurement for quantifying antibiotic consumption.
• To investigate the relationship between antibiotic use metrics and antibiotic resistance risks.
• To assess the utility of DDD per 100 admissions as a complementary indicator.

Main Methods:

• Analysis of antibiotic use trends in Dutch acute care hospitals from 1997 to 2001.
• Antibiotic consumption data were expressed as DDD per 100 patient days and DDD per 100 admissions.
• Changes in hospital resource indicators (patient days, admissions, length of stay) were also analyzed.

Main Results:

• Total systemic antibiotic use increased significantly when measured in DDD per 100 patient days (47.2 to 54.7).
• However, antibiotic use remained constant when measured in DDD per 100 admissions.
• Discrepancies were observed between the two metrics for individual antibiotics, and hospital resource indicators significantly decreased.

Conclusions:

• Understanding variations in resource indicators is crucial for interpreting antibiotic use data in DDD per 100 patient days.
• Expressing antibiotic use in DDD per 100 admissions offers a more stable and interpretable measure.
• Further research is necessary to establish correlations between antibiotic use measures and antibiotic resistance levels.