Meier Nick Frørup, Hertz Frederik Boëtius, Granholm Anders, Perner Anders, Sjövall Fredrik, Svan Kathrine Bruun, Møller Morten Hylander, Helleberg Marie
Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Microbiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2025 Oct;69(9):e70124. doi: 10.1111/aas.70124.
Antibiotics are widely used in intensive care units (ICUs), yet detailed nationwide data on ICU-specific consumption are limited. In 2012, the Danish Health Authority introduced a policy framework to promote prudent antibiotic use. We evaluated national trends in antibiotic consumption across Danish ICUs from 2013 to 2023 considering this initiative.
We conducted a nationwide observational study including all adult ICUs across 29 public hospitals in Denmark. All ICU admissions from January 1, 2013, to December 31, 2023, were included, covering 1,121,639 ICU patient days. Antibiotic consumption was assessed using defined daily doses (DDD) derived from national sales data. No interventions were implemented.
During the study period, a total of 1,624,281 DDD of intravenous antibiotics were administered. Overall antibiotic consumption declined from 1705 to 1348 DDD per 1000 patient days, representing a 21% relative reduction. Marked decreases were observed for fluoroquinolones (-80%), first- and second-generation cephalosporins (-61%), and carbapenems (-34%). Conversely, consumption of penicillins with beta-lactamase inhibitors increased by 139%. Run chart analyses indicated these trends were non-random. Importantly, no deterioration in clinical outcomes was observed. Antibiotic consumption varied widely across ICUs and regions. According to both WHO's AWaRe framework and a modified national classification, 'Watch' antibiotics accounted for the largest share of consumption.
In this nationwide study of Danish ICUs, antibiotic consumption decreased substantially over an 11-year period-driven by reductions in broad-spectrum classes-without evidence of worsening clinical outcomes. These data document a sustained decline in broad-spectrum antibiotic use in Danish intensive-care practice and may provide a benchmark for other high-income healthcare systems.
This inventory of antibiotics consumption in Danish intensive care units demonstrates a recent reduction in broad-spectrum antibiotic ordering which differs from the well-known increase of antibiotics used in health care in general.
抗生素在重症监护病房（ICU）中广泛使用，但全国范围内关于ICU特定使用情况的详细数据有限。2012年，丹麦卫生当局引入了一个政策框架以促进谨慎使用抗生素。考虑到这一举措，我们评估了2013年至2023年丹麦各ICU抗生素使用的全国趋势。
我们进行了一项全国性观察性研究，纳入了丹麦29家公立医院的所有成人ICU。纳入了2013年1月1日至2023年12月31日期间所有的ICU入院病例，涵盖1,121,639个ICU患者日。使用从全国销售数据得出的限定日剂量（DDD）来评估抗生素使用情况。未实施任何干预措施。
在研究期间，共使用了1,624,281 DDD的静脉用抗生素。总体抗生素使用量从每1000患者日1705 DDD降至1348 DDD，相对减少了21%。氟喹诺酮类（-80%）、第一代和第二代头孢菌素（-61%）以及碳青霉烯类（-34%）的使用量显著下降。相反，含β-内酰胺酶抑制剂的青霉素类使用量增加了139%。趋势图分析表明这些趋势并非随机。重要的是，未观察到临床结局恶化。各ICU和地区的抗生素使用量差异很大。根据世界卫生组织的AWaRe框架和一种改良的国家分类，“谨慎使用”的抗生素在使用量中占比最大。
在这项针对丹麦ICU的全国性研究中，在11年期间抗生素使用量大幅下降——这是由广谱类别抗生素的减少所驱动的——且没有临床结局恶化的证据。这些数据表明丹麦重症监护实践中广谱抗生素的使用持续减少，可能为其他高收入医疗系统提供一个基准。
这份丹麦重症监护病房抗生素使用情况清单显示，近期广谱抗生素的医嘱量有所减少，这与总体医疗保健中抗生素使用量的普遍增加不同。
