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Changes in patterns of antimicrobial use in Swedish hospitals 2003 to 2006 following the introduction of large-scale nation wide point prevalence studies (PPS). Erntell M, Skoog G, Cars O, Elowson S, Hanberger H, Jorup C, Odenholt I, Prag M, Skärlund K, Struwe J, Torell E, Ulleryd P
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Changes in patterns of antimicrobial use in Swedish hospitals 2003 to 2006 following the introduction of large-scale nation wide point prevalence studies (PPS) Erntell M, Skoog G, Cars O, Elowson S, Hanberger H, Jorup C, Odenholt I, Prag M, Skärlund K, Struwe J, Torell E, Ulleryd P The Strama programme, Stockholm Sweden
Swedish Point Prevalence StudiesPPS 2003, 2004 and 2006(For method, Skoog, ECCMID 2004) 2003 2004 2006 • No of hospitals 54 49 64 • No of admitted pat 13,536 11,348 17,113 • No of therapies 4,396 3,841 6,012 • Therapies, total no 14,249
PPS 2003 / 2004 / 2006Therapyreasons Admitted patients treated for (%): 2003 2004 2006 • Community acquired 17,0 18,0 18,7 • Hospital acquired 9,2 9,4 9,9 • Prophylaxis 6,3 6,5 6,3 • Total 32,5 33,9 34,9
Antibiotic ”pressure” PPS 2003 - 2006 DDD/100 admitted patients • PPS 2003 40.3 • PPS 2004 43.1 • PPS 2006 43.3 • ESAC PPS 2006 47.6 (ECCMID 2007)
Relative distribution of antibiotics in treatment of community acquired infections, PPS 2003 and 2006
Areas for intervention before PPS 2006 Leaflet to all specialists and information: • Length of peri-operative prophylaxis • Community acquired pneumonia • Reduction of Fluoroquinolones in community acquired cystitis in women
PPS 2003 – 2006 Length of perioperative prophylaxis in colo-rectal surgery
Treatment for community acquired pneumonia at Depts. of Internal medicine, PPS 2003+2004 compared to PPS 2006
Treatment of community acquired cystitis in women PPS 2003 - 2006
Hospital acquired infections (HAI), comparison between the PPS 2003 and 2006 of the different types
Conclusions The PPS method has become a valuable tool to describe the antibiotic use in relation to diagnose • We have observed: • shorter courses of peri-operative prophylaxis • Less fluoroquinolones in treatment of community acquired cystitis in women • No changes in treatment of CAP – more than 35 % of all treatments included cephalosporins
Swedish strategic programme against antibiotic resistance