Institute of Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany.
German National Reference Centre for Surveillance of Nosocomial Infections (NRZ), Hindenburgdamm 27, 12203 Berlin, Germany.
J Antimicrob Chemother. 2018 Apr 1;73(4):1077-1083. doi: 10.1093/jac/dkx494.
Previous point prevalence surveys (PPSs) revealed the potential for improving antimicrobial usage (AU) in German acute care hospitals. Data from the 2016 German national PPS on healthcare-associated infections and AU were used to evaluate efforts in antimicrobial stewardship (AMS).
A national PPS in Germany was organized by the German National Reference Centre for Surveillance of Nosocomial Infections in 2016 as part of the European PPS initiated by the ECDC. The data were collected in May and June 2016. Results were compared with data from the PPS 2011.
A total of 218 hospitals with 64 412 observed patients participated in the PPS 2016. The prevalence of patients with AU was 25.9% (95% CI 25.6%-26.3%). No significant increase or decrease in AU prevalence was revealed in the group of all participating hospitals. Prolonged surgical prophylaxis was found to be common (56.1% of all surgical prophylaxes on the prevalence day), but significantly less prevalent than in 2011 (P < 0.01). The most frequently administered antimicrobial groups were penicillins plus β-lactamase inhibitors (BLIs) (23.2%), second-generation cephalosporins (12.9%) and fluoroquinolones (11.3%). Significantly more penicillins plus BLIs and fewer second-generation cephalosporins and fluoroquinolones were used in 2016. Overall, an increase in the consumption of broad-spectrum antimicrobials was noted. For 68.7% of all administered antimicrobials, the indication was documented in the patient notes.
The current data reaffirm the points of improvement that previous data identified and reveal that recent efforts in AMS in German hospitals require further intensification.
先前的时点患病率调查（PPS）显示，德国急性医疗机构中抗菌药物使用（AU）有改进的潜力。利用 2016 年德国全国关于医院获得性感染和 AU 的 PPS 数据，评估抗菌药物管理（AMS）的努力。
2016 年，德国国家参考中心为欧洲疾病预防控制中心发起的 PPS 项目的一部分，在德国组织了全国性的 PPS。数据于 2016 年 5 月和 6 月收集。结果与 2011 年 PPS 的数据进行了比较。
共有 218 家医院的 64412 例观察患者参与了 2016 年的 PPS。AU 患者的患病率为 25.9%（95%CI 25.6%-26.3%）。所有参与医院的 AU 患病率均未显示出显著的增加或减少。普遍存在手术预防时间过长的情况（流行日所有手术预防的 56.1%），但明显少于 2011 年（P<0.01）。使用最频繁的抗菌药物组是青霉素加β-内酰胺酶抑制剂（BLIs）（23.2%）、第二代头孢菌素（12.9%）和氟喹诺酮类（11.3%）。2016 年，青霉素加 BLIs 的使用明显增加，而第二代头孢菌素和氟喹诺酮类的使用减少。总的来说，广谱抗菌药物的使用量有所增加。所有使用的抗菌药物中，有 68.7%的药物的适应证在患者病历中有记录。
目前的数据再次证实了先前数据确定的改进要点，并显示德国医院最近在 AMS 方面的努力需要进一步加强。
