Antimicrobials are commonly used in acute care hospitals for the treatment of both community-acquired and healthcare-associated infections (HAIs), and for surgical prophylaxis [1]. Studies have indicated that some antimicrobial use may be unnecessary and in instances when use is required, the selection, dose, route of administration and duration of treatment may be inappropriate [2,3]. Through selection pressure, antimicrobials contribute to the emergence and spread of antimicrobial resistance (AMR) [4]. Moreover, antimicrobial use has adverse consequences, including HAIs caused by Clostridium difficile [5,6], multidrug-resistant organisms [7] and fungi [8].

Data on antimicrobial consumption in acute care hospitals are necessary to assess the magnitude, the reasons and determinants of antimicrobial use and to inform public health policies that are promoting prudent use of antimicrobials. In June 2017, the European Commission published the European guidelines for the prudent use of antimicrobials in human medicine [9]. These guidelines recommend establishing antimicrobial stewardship programmes in all healthcare facilities. Although antimicrobial consumption in hospitals is measured at a national level by some EU/EEA countries, methodologies are not always consistent between countries and therefore preclude valid comparisons. The European Surveillance of Antimicrobial Consumption Network (ESAC-Net) monitors the use of antimicrobials in the EU/EEA, but does not provide uniform information on antimicrobial use in hospitals and does not include clinical data to assess the appropriateness of antimicrobial prescriptions [10].

Point prevalence surveys (PPSs) are a feasible method to assess antimicrobial use in hospitals, and their value in identifying targets for interventions has been demonstrated [2,11]. The European Centre for Disease Prevention and Control (ECDC) PPS of HAIs and antimicrobial use in European acute care hospitals applies a standardised methodology for the estimation of the prevalence of both HAIs and antimicrobial use across the EU/EEA. The first ECDC PPS in 2011–12 indicated that 32.7% of patients in acute care hospitals received one or more antimicrobial agents on the day of the survey, which translated to more than 450,000 patients receiving at least one antimicrobial agent on any given day in European acute care hospitals [1].

In this study, based on data from the second PPS in 2016–17, we aimed at estimating the prevalence of antimicrobial use and describing the indications and the prescribed antimicrobial agents. Further, we aimed to raise awareness, identify targets for improvement and provide a standardised tool for evaluating the effect of local, regional and national policies on strengthening prudent use of antimicrobials in European acute care hospitals.

klik hier voor volledig artikel, gepubliceerd in Eurosurveillance Volume 23, Issue 46, 15 nov 2018

Auteurs: Diamantis Plachouras1, Tommi Kärki1, Sonja Hansen2, Susan Hopkins3, Outi Lyytikäinen4, Maria Luisa Moro5, Jacqui Reilly6,7, Peter Zarb8, Walter Zingg9, Pete Kinross1, Klaus Weist1, Dominique L. Monnet1, Carl Suetens1, the Point Prevalence Survey Study Group10

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