Antimicrobial use trends, Israel, 2012 to 2017

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Healthcare Management

Background:

• Israel's National Center for Infection Control launched a national antimicrobial stewardship programme in 2012.
• This programme mandated annual reporting of antimicrobial drug usage across the nation.
• Nationwide data from 2012 to 2017 are presented to assess the programme's impact.

Purpose of the Study:

• To evaluate trends in antimicrobial consumption in Israel.
• To determine the impact of the national stewardship programme on antimicrobial use.
• To analyze antimicrobial usage patterns across different healthcare settings.

Main Methods:

• A retrospective observational study design was employed.
• Data were collected from health maintenance organizations (HMOs), acute care hospitals (medical/surgical wards and ICUs), and post-acute care hospitals (PACHs).
• Antimicrobial use was quantified using defined daily doses (DDD) per 1,000 insured per day (community) and per 100 patient-days (hospitals/PACHs), with trend analysis via linear regression.

Main Results:

• Antimicrobial use showed a significant decrease across all studied sectors between 2012 and 2017.
• Community use declined modestly by 4.4% (22.8 to 21.8 DDD/1,000 insured/day).
• Acute care hospital use decreased by 11.1%–16.5% (medical, surgical, and ICU wards), with the most significant reduction observed in PACHs (37.8%).

Conclusions:

• The nationwide antimicrobial stewardship programme in Israel was associated with a significant decrease in antimicrobial use.
• Reductions were observed across community, acute care hospital, and post-acute care settings.
• These findings highlight the effectiveness of a national stewardship initiative in curbing antimicrobial consumption.