Department of Nosocomial Infections, Surveillance of Antibiotic Resistance and Antibiotic Consumption, Robert Koch Institute, Seestr. 10, D-13353 Berlin, Germany.
Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Hindenburgdamm 27, D-12203 Berlin, Germany.
J Antimicrob Chemother. 2018 Dec 1;73(12):3505-3515. doi: 10.1093/jac/dky345.
The features of a newly established, web-based surveillance system for hospital antibiotic consumption are described and data on broad-spectrum antibiotic use in German acute care hospitals are presented.
The watch- and reserve-group antibiotics, two categories of antibiotics derived from the WHO Essential Medicines List comprising key agents for antimicrobial stewardship, were used as a framework for data analysis. The median antibiotic consumption densities (ACDs; DDD/100 patient days) for the years 2015/16 based on data from 137 acute care hospitals have been calculated for whole facilities, ICUs and medical and surgical departments, stratified by type of care.
The new web-based system provides real-time surveillance at unit and facility levels, accessible to all relevant stakeholders. User-defined reports are available via an interactive database, various report types support different approaches to analysis, and different complementing quantification measures of antimicrobial consumption are available. Watch- and reserve-group antibiotics accounted for 42% and 2% of total antibiotic use, respectively. Surgical services presented with considerably lower median ACDs of the watch-group antibiotics compared with medical services. Tertiary care hospitals exhibited higher ACDs of the reserve-group antibiotics and carbapenems than primary/secondary care hospitals, while the ACDs of the watch-group antibiotics as a whole did not differ significantly. Comparing the proportional use with other European countries revealed a relatively high use of the watch-group, ranking beyond the 75th percentile.
Because of its particular features the new web-based surveillance system is a valuable tool for antimicrobial stewardship. The WHO categories of watch- and reserve-group antibiotics proved to be a useful framework for the analysis of hospital antibiotic consumption data.
描述一个新建立的基于网络的医院抗生素使用监测系统的特点，并介绍德国急性护理医院广谱抗生素使用的数据。
以世界卫生组织基本药物清单中的两类抗生素（观察储备类抗生素）为分析数据的框架，这两类抗生素包括抗菌药物管理的关键药物。根据 137 家急性护理医院的数据，计算了 2015/16 年整个医疗机构、重症监护病房和内科及外科病房的抗生素消耗密度（DDD/100 患者天），按护理类型进行分层。
新的基于网络的系统在单位和设施层面提供实时监测，所有相关利益攸关方均可使用。通过交互式数据库提供用户定义的报告，各种报告类型支持不同的分析方法，并且有不同的补充抗菌药物消耗定量措施。观察储备类抗生素分别占抗生素总使用量的 42%和 2%。与内科相比，外科服务的观察类抗生素的平均消耗密度明显较低。三级保健医院的储备类抗生素和碳青霉烯类药物的消耗密度高于一级/二级保健医院，而观察类抗生素的消耗密度整体没有显著差异。与其他欧洲国家的比例使用情况相比，观察类抗生素的使用相对较高，排名在前 75%。
由于其独特的特点，新的基于网络的监测系统是抗菌药物管理的一个有价值的工具。观察储备类抗生素这一世界卫生组织类别被证明是分析医院抗生素使用数据的有用框架。
