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SDG 3: Antimicrobial resistance

Abstract

Background

Non-university hospitals are the major provider of inpatient care in Germany, serving 89% of acute care hospital beds. Although surveillance data on antimicrobial use in hospitals are widely available, data on prescription quality are rare.

Aim

We aimed to provide an in-depth analysis of antimicrobial prescribing patterns and quality in southwest German non-university hospitals.

Methods

During 2021, we performed three point prevalence surveys (PPS) in 10 non-university hospitals, representing ca 10% of hospital beds in the federal state of Baden-Württemberg (11 million inhabitants). Demographic and clinical information were collected. We assessed the overall performance of 14 validated process quality indicators (QI) covering infection diagnostics, antimicrobial therapy and documentation.

Results

Of 8,560 patients analysed, 2,861 (33%) received at least one antimicrobial. Most (2,789, 80%) antimicrobial prescriptions were for therapeutic indications. Most frequently prescribed agents were beta-lactam/beta-lactamase inhibitors (1,120, 40%) in therapeutic and cefuroxime (269, 37%) in prophylactic indications. According to the World Health Organization’s Access, Watch, Reserve classification, the Access-to-Watch ratio was 0.73. Overall adherence to QIs was low and varied substantially (27–93%), with documentation, possible streamlining and switching to oral therapy exhibiting the lowest fulfilment rates (< 50%).

Conclusion

The results indicate a need to improve antimicrobial prescribing quality in non-university hospitals. The high prevalence of antimicrobial use in our setting underlines the demand for sustainable antimicrobial stewardship programmes in this sector. Our QI-based PPS approach can be used to identify key targets for future antimicrobial stewardship interventions. The results indicate a need for further legislation on antimicrobial stewardship.

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2024-11-14
2024-12-18
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An in-depth analysis of antimicrobial prescription quality in 10 non-university hospitals, in southwest Germany, 2021
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Gesche+F%C3%B6rst&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Först Gesche</a>, <a href="/search?value1=Roland+Giesen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Giesen Roland</a>, <a href="/search?value1=Geertje+Fink&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fink Geertje</a>, <a href="/search?value1=Matthias+Sehlbrede&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sehlbrede Matthias</a>, <a href="/search?value1=Nicole+Wimmesberger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wimmesberger Nicole</a>, <a href="/search?value1=Rebekka+Allen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Allen Rebekka</a>, <a href="/search?value1=Kerstin+Meyer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meyer Kerstin</a>, <a href="/search?value1=Sabine+M%C3%BCller&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Müller Sabine</a>, <a href="/search?value1=Hanna+Niese&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Niese Hanna</a>, <a href="/search?value1=Sina+Polk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Polk Sina</a>, <a href="/search?value1=Barbara+Reistle&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reistle Barbara</a>, <a href="/search?value1=Carolin+Schuhmacher&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schuhmacher Carolin</a>, <a href="/search?value1=Andreas+von+Ameln-Meyerhofer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">von Ameln-Meyerhofer Andreas</a>, <a href="/search?value1=Kim+Winter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Winter Kim</a>, <a href="/search?value1=Dave+Wirth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wirth Dave</a>, <a href="/search?value1=Winfried+V+Kern&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kern Winfried V</a>, <a href="/search?value1=Erik+Farin-Glattacker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Farin-Glattacker Erik</a>, <a href="/search?value1=Siegbert+Rieg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rieg Siegbert</a>, <a href="/search?value1=the+ID+ROLL+OUT+Study+group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">the ID ROLL OUT Study group</a></span>. An in-depth analysis of antimicrobial prescription quality in 10 non-university hospitals, in southwest Germany, 2021. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(46):pii=2400156. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.46.2400156" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.46.2400156</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 11 Mar 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 02 Jul 2024 </span> </p>
/content/10.2807/1560-7917.ES.2024.29.46.2400156
/content/10.2807/1560-7917.ES.2024.29.46.2400156
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