CPIAS Nouvelle-Aquitaine, CHU de Bordeaux, Bordeaux, France.
Univ. Bordeaux, INSERM, BPH, U1219, Team AHeaD, Bordeaux, France.
Infect Control Hosp Epidemiol. 2024 Jun;45(6):740-745. doi: 10.1017/ice.2024.19. Epub 2024 Feb 19.
Monitoring antibiotic consumption is a key component to steer antimicrobial stewardship programs, including in nursing homes. We analyzed changes in antibiotic consumption in French nursing homes during 5 years, including the COVID-19 pandemic, to identify potential priorities for improvement.
A multicenter survey was conducted between 2018 and 2022.
The study was conducted across 220 French nursing homes with on-site pharmacies.
Antibiotic consumption data were collected from pharmacy records and are expressed as defined daily doses per 1,000 resident days. Antibiotic indicators promoted by health authorities were calculated from quantitative data to evaluate the quality of prescribing.
Antibiotic consumption significantly decreased between 2018 and 2022, particularly during the coronavirus disease 2019 (COVID-19) pandemic, despite a slight increase in 2022. During the study period, the most used antibiotic classes were penicillins (61.9% in 2022) followed by cephalosporins (10.5%), macrolides-lincosamides-streptogramins (7.3%) then fluoroquinolones (7.0%). Amoxicillin-clavulanic acid was the most consumed antibiotic; amoxicillin and ceftriaxone ranked second and third. Azithromycin consumption increased from 2020, as did the indicator regarding broad-spectrum antibiotics.
The decreasing trend in antibiotic use and control of fluoroquinolone use over the study period suggest compliance with antibiotic use guidelines. However, changes in the use of broad-spectrum antibiotics and the substantial use of amoxicillin-clavulanic acid, although it is rarely a first-line antibiotic, highlight the need for antimicrobial stewardship activities and the usefulness of antibiotic consumption surveillance to identify priorities.
监测抗生素的使用情况是指导抗菌药物管理计划的关键组成部分，包括在养老院中。我们分析了 5 年内法国养老院中抗生素的使用变化情况，包括 COVID-19 大流行期间，以确定可能需要改进的优先事项。
在 2018 年至 2022 年期间进行了一项多中心调查。
这项研究在 220 家拥有现场药房的法国养老院进行。
从药房记录中收集抗生素使用数据，并表示为每 1000 个居民天的限定日剂量。从定量数据中计算出卫生当局推荐的抗生素指标，以评估处方质量。
尽管 2022 年略有增加，但 2018 年至 2022 年间，抗生素的使用量显著下降，尤其是在 COVID-19 大流行期间。在研究期间，使用最多的抗生素类别是青霉素（2022 年为 61.9%），其次是头孢菌素（10.5%）、大环内酯类-林可酰胺类-链阳性菌素类（7.3%），然后是氟喹诺酮类（7.0%）。阿莫西林-克拉维酸是使用最多的抗生素；阿莫西林和头孢曲松分别排名第二和第三。阿奇霉素的使用量从 2020 年开始增加，广谱抗生素的指标也是如此。
研究期间抗生素使用呈下降趋势，氟喹诺酮类药物的使用得到控制，这表明抗生素使用指南得到了遵守。然而，广谱抗生素使用的变化以及阿莫西林-克拉维酸的大量使用（尽管它很少作为一线抗生素）突出了需要开展抗菌药物管理活动，并指出了使用抗生素消耗监测来确定优先事项的重要性。
