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Abstract

Background

Robust data on the quality of antimicrobial prescriptions in German acute care hospitals are scarce. To establish and implement antimicrobial stewardship (AMS) measures and to increase prudent antimicrobial use (AMU), the identification of appropriate process and quality indicators is pertinent.

Aim

Our main objective was to identify parameters associated with adequate AMU and inadequate AMU by analysing point prevalence data. Our secondary goal was to describe the current state of AMS implementation in Germany.

Methods

A national point prevalence survey for healthcare-associated infections and AMU was conducted in German hospitals in 2016. Data on structure and process parameters were also collected. Recorded antimicrobial prescriptions were divided into adequate, inadequate and undefinable AMU. A multivariable linear regression analysis was performed to examine the correlation of selected structure and process parameters with the adequacy of recorded antimicrobials.

Results

Data from 218 acute care hospitals, 64,412 patients and 22,086 administered antimicrobials were included. Multivariable linear regression analysis revealed that documentation of a reason for AMU in the patient notes increased the likelihood of adequate AMU and decreased the likelihood of inadequate AMU significantly (p < 0.001), while tertiary care hospital type had the opposite effect (p < 0.001).

Conclusion

Through associating structural and process parameters with adequacy of AMU, we identified parameters that increased the odds of prudent AMU. Documentation was a key element for improving AMU. Revealed deficits regarding the implementation of AMS in German hospitals concerning dedicated staff for AMS activities and establishment of regular AMU training and AMU audits should be tackled.

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2019-11-14
2024-12-22
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The quality of antimicrobial prescribing in acute care hospitals: results derived from a national point prevalence survey, Germany, 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Seven+Johannes+Sam+Aghdassi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aghdassi Seven Johannes Sam</a>, <a href="/search?value1=Frank+Schwab&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schwab Frank</a>, <a href="/search?value1=Sonja+Hansen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hansen Sonja</a>, <a href="/search?value1=Luis+Alberto+Pe%C3%B1a+Diaz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Peña Diaz Luis Alberto</a>, <a href="/search?value1=Michael+Behnke&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Behnke Michael</a>, <a href="/search?value1=Petra+Gastmeier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gastmeier Petra</a>, <a href="/search?value1=Tobias+Siegfried+Kramer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kramer Tobias Siegfried</a></span>. The quality of antimicrobial prescribing in acute care hospitals: results derived from a national point prevalence survey, Germany, 2016. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(46):pii=1900281. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.46.1900281" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.46.1900281</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 06 May 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 30 Aug 2019 </span> </p>
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