Henard S, Rahib D, Léon L, Amadéo B, Dumartin C, Cavalié P, Coignard B
Institut de veille sanitaire, Saint-Maurice, France.
Med Mal Infect. 2011 Apr;41(4):197-205. doi: 10.1016/j.medmal.2010.11.013. Epub 2010 Dec 30.
The study's objective was to describe the evolution of antibiotic consumption between 2006 and 2008 in French health care facilities (HCF) its relations with the national policy of good antibiotics use using the ICATB score.
Data from standardized reports on infection control activities collected from 2006 to 2008 by the Ministry of Health (antibiotic consumptions and elements of antibiotic stewardship of every HCF) were analyzed with linear regression models to multilevel random intercept adjusted on HCF characteristics (public or private) and activity.
The analysis was performed on 4062 (48,2%) observations after exclusion of HCF not concerned by the ICATB public reporting indicator (7.2% of observations), invalid or missing data (21,2% of observations) and irrelevant values (23.4%). The global antibiotic consumption was 343 defined daily doses (DDD) per 1000 patient-days (PD) and varied little between 2006 and 2008. However, the linear regression model showed an increase of 5.7 DDD per 1000 PDs per year (P<0.001). There was a positive association between antibiotic consumption and ICATB score, mainly concerning sub-scores ICATB-action and ICATB-organization.
The recent lack of decrease in antibiotic consumption in French HCF between 2006 and 2008 is coherent with other available national data, but exclusion of more than 50% of observations limits the impact of this analysis. The relationship between policy of good use and consumption of antibiotics remain difficult to specify, because of the short (three years) study length and because of the nature of ICATB, a composite indicator assessing only partly antibiotic policies.
本研究的目的是描述2006年至2008年法国医疗保健机构(HCF)抗生素消费的演变情况,以及其与使用ICATB评分的国家合理使用抗生素政策之间的关系。
对卫生部在2006年至2008年收集的关于感染控制活动的标准化报告数据(每个HCF的抗生素消费情况和抗生素管理要素)进行分析,采用线性回归模型,对HCF特征(公立或私立)和活动进行多水平随机截距调整。
在排除未受ICATB公共报告指标影响的HCF(占观察值的7.2%)、无效或缺失数据(占观察值的21.2%)以及无关值(占观察值的23.4%)后,对4062个(48.2%)观察值进行了分析。全球抗生素消费量为每1000患者日(PD)343限定日剂量(DDD),2006年至2008年间变化不大。然而,线性回归模型显示每年每1000 PD增加5.7 DDD(P<0.001)。抗生素消费与ICATB评分之间存在正相关,主要涉及ICATB-行动和ICATB-组织子评分。
2006年至2008年法国HCF近期抗生素消费缺乏下降与其他可用的国家数据一致,但排除超过50%的观察值限制了该分析的影响。由于研究时间短(三年)以及ICATB的性质(一种仅部分评估抗生素政策的综合指标),合理使用政策与抗生素消费之间的关系仍难以明确。