Surveys demonstrate similar rates of hospital antimicrobial use in 2011, 2015
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Overall antimicrobial use in hospitals occurred at similar rates in 2011 and 2015, although differences were noted in certain patient or antimicrobial groups, according to findings published in Clinical Infectious Diseases.
The findings “may provide evidence” for the impact of antimicrobial stewardship programs, the researchers note.
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“We performed our first full-scale prevalence survey of health care-associated infections and antimicrobial use in hospitals in 2011,” Shelley S. Magill, MD, PhD, a medical officer in the CDC’s Division of Healthcare Quality Promotion, told Healio. “We repeated the survey in 2015 to describe whether there had been changes in the prevalence and types of infections and antimicrobial use since the 2011 survey.”
Magill and colleagues used data on antimicrobial medications collected through the CDC’s Emerging Infections Program, which enlisted general and women’s and children’s hospitals to take a survey between May and September 2015. Medical records for a random patient sample on the survey date were examined to gather data on antimicrobial medications administered on the survey date or day before. The researchers then compared percentages of patients on antimicrobial medications and analyzed factors associated with their use.
According to Magill, the surveys did not show a difference in the rate of hospital antimicrobial use in the 2011 and 2015 surveys.
Among 12,299 patients in 199 hospitals, 6,084 (49.5%; 95% CI, 48.6%-50.4%) were given antimicrobials. Overall rates of antimicrobial use were similar in 2011 and 2015 among 148 hospitals in both surveys, although the percentage of neonatal critical care patients on antimicrobials was lower in 2015 (22.8% vs 32% in 2011; P = .006). The study showed that fluoroquinolone use was lower in 2015 (10.1% of patients vs. 11.9% in 2011; P < .001). Third- or fourth-generation cephalosporin use was higher (12.2% vs. 10.7% in 2011), as was carbapenem use (3.7% vs. 2.7% in 2011; P < .001).
According to Magill, while the study did not directly evaluate whether antimicrobial medications were being used correctly, the results show that there is “room for improving the way antimicrobial medications are used in hospitals.” The researchers did find differences in selected patient or antimicrobial groups that may offer evidence for the impact of antimicrobial stewardship programs.
“Prevalence surveys remain a valuable complement to other large-scale assessments of hospital antimicrobial use, including data from the National Healthcare Safety Network’s Antimicrobial Use Option,” Magill said. “These surveys, including a similar survey conducted in nursing homes in 2017, provide opportunities to assess not only the prevalence of antimicrobial use in health care facilities but also the reasons for and the quality of use at the patient level. We are currently finalizing analyses of additional data from the 2015 prevalence survey to describe the quality of antimicrobial treatment in selected hospital patients.”
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