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Trends in antimicrobial use from 1999 to 2001 in 36 US Hospitals A SCOPE-MMIT report



Trends in antimicrobial use from 1999 to 2001 in 36 US Hospitals A SCOPE-MMIT report



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 42: 419



Background: Many organizations have documented patterns of antimicrobial resistance of bacteria in hospitals on a national scale. However, the patterns of AU are not readily available. SCOPE (Surveillance and Control of Pathogens of Epidemiologic importance) has an alliance with MediMedia Information Technology (MMIT, Yardley, PA) that allows us to quantify all antimicrobial drugs dispensed to inpatients in participating U.S. hospitals. We have evaluated trends in AU between 1999 and 2001. Methods: Total grams for 61 antimicrobials and total patient days (PD) from 36 hospitals for 1999 through 2001 were determined from electronic capture of billing records. The defined daily dose/1000PD (DDD/1000PD) for each antimicrobial for the three study years was calculated and sorted from the highest to the lowest. The 20 most dispensed antimicrobials for each year were analyzed. Results: Total AU in 1999, 2000 and 2001 was 1019, 897, and 955 DDD/1000PD, respectively. Cefazolin was the most dispensed antimicrobial for 1999, 2000, and 2001 (130, 108, 138 DDD/1000 PD respectively); ceftriaxone use decreased from the second most dispensed antimicrobial in 1999 to the third most dispensed in 2000 and 2001 (106, 94, 96 DDD/1000PD, respectively); levofloxacin use increased from the third most dispensed antimicrobial in 1999 to the second most dispensed in 2000 and 2001 (77, 97, 110 DDD/1000PD respectively). Comparing 1999 to 2001 AU, levofloxacin use increased greatest (30%) followed by piperacillin/tazobactam (18%) and azithromycin (16%). TMP/SMX use declined the most (42%) followed by nafcillin (38%) and cefuroxime (29%). Other changes noted are ciprofloxacin (25%dwnarw), metronidazole (25%dwnarw), and ceftazidime (24%dwnarw). Use of other antimicrobials did not change significantly between 1999 and 2001. Conclusions: Total AU has not increased over the past 3 years, but there are major changes between and within different classes of AU. These changes are likely to result in shifting patterns of bacterial resistance.

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