Harbin Nicolay Jonassen, Haug Jon Birger, Romøren Maria, Lindbæk Morten
Department of Infection Control, Østfold Health Trust, Kalnes, Norway.
Centre for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
JAC Antimicrob Resist. 2020 Oct 29;2(4):dlaa093. doi: 10.1093/jacamr/dlaa093. eCollection 2020 Dec.
Norwegian nursing homes (NHs) have over the last 10 years increasingly applied the use of parenteral treatment, which in turn allows more broad-spectrum use of antibiotics. Previous studies from Norwegian NHs have for the most part not described parenteral formulations.
To describe systemic antibiotic use in Norwegian NHs.
Thirty-seven NHs in the county of Østfold, Norway, were invited to participate in this retrospective cross-sectional study. Associated pharmacies provided sales data for systemic antibiotic use for the participating NHs for 1 year (October 2015 to October 2016). General institutional characteristics were collected through a questionnaire.
Thirty-four NHs participated in the study. Mean use of antibiotics was 10.0 DDD/100 bed days (range 0.6-30.9 DDD/100 bed days). Oral antibiotics accounted for 83% and parenteral antibiotics for 17% of the total antibiotic use. Of parenteral antibiotics, ampicillin was most used (31.1%) followed by cefotaxime (17.7%) and penicillin G (16.6%). The proportion of antibiotics compliant with guideline recommendations was 60%. Being a short-term NH was associated with increased antibiotic use, with an unstandardized coefficient of 13.1 (95% CI 4.2-21.9; =0.005).
We found a high level of total and parenteral antibiotic use compared with previous studies from Norwegian NHs. Data showed wide variations in total antibiotic use and that only a moderate proportion of the antibiotic use was considered guideline compliant. This highlights the necessity of further implementation strategies regarding the national guidelines for antibiotic use in NHs.
在过去10年里，挪威养老院越来越多地采用肠外治疗，这反过来又使得抗生素的使用范围更广。挪威养老院此前的研究大多未描述肠外制剂。
描述挪威养老院全身用抗生素的使用情况。
邀请挪威东福尔郡的37家养老院参与这项回顾性横断面研究。相关药房提供了参与研究的养老院1年（2015年10月至2016年10月）全身用抗生素的销售数据。通过问卷调查收集一般机构特征。
34家养老院参与了研究。抗生素的平均使用量为10.0限定日剂量/100床日（范围为0.6 - 30.9限定日剂量/100床日）。口服抗生素占总抗生素使用量的83%，肠外抗生素占17%。在肠外抗生素中，氨苄西林使用最多（31.1%），其次是头孢噻肟（17.7%）和青霉素G（16.6%）。符合指南推荐的抗生素比例为60%。作为短期养老院与抗生素使用增加相关，未标准化系数为13.1（95%置信区间4.2 - 21.9；P = 0.005）。
与挪威养老院此前的研究相比，我们发现全身用和肠外抗生素的使用水平较高。数据显示总抗生素使用存在很大差异，且只有适度比例的抗生素使用被认为符合指南。这突出了进一步实施有关养老院抗生素使用国家指南的策略的必要性。
