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Antimicrobial Use among Adult Inpatients in Northern Canada, 2019-2021.

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Antimicrobial use in northern Canadian hospitals increased by 49% from 2019 to 2021, driven by cephalosporin use. This data is crucial for antimicrobial stewardship programs in the region.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Pharmacology

Background:

  • Limited data exists on inpatient antimicrobial use in northern Canada, hindering effective stewardship.
  • Northern Canada is defined as the territories and Statistics Canada's provincial north.

Purpose of the Study:

  • To describe antimicrobial use patterns for inpatients in northern Canadian acute care hospitals.
  • To provide data for antimicrobial stewardship initiatives.

Main Methods:

  • Collected annual systemic antimicrobial use data (defined daily doses per 1000 patient days) from 42-47 hospitals between 2019-2021.
  • Utilized the Anatomical Therapeutic Chemical (ATC) classification system and WHO's AWaRe (Access/Watch/Reserve) categories.
  • Included adult or mixed adult and pediatric populations.

Main Results:

  • A 49% relative increase in overall antimicrobial use was observed from 2019 (401 DDD/1000pd) to 2021 (596 DDD/1000pd).
  • Significant increases in third-generation (80%) and first-generation (64%) cephalosporin use were noted.
  • Antimicrobials in the 'Reserve' category increased from 0.4% to 2% of total use.

Conclusions:

  • This study provides the most extensive inpatient antimicrobial use data for northern Canada to date.
  • The rise in antimicrobial consumption, particularly cephalosporins, warrants attention for stewardship efforts.
  • Findings may have limited generalizability to all northern hospitals due to regional variations.