Antimicrobial use in Canadian acute-care hospitals: Findings from three national point-prevalence surveys between 2002 and 2017. (7th November 2022)

• Record Type: Journal Article
• Authors: Liang, Jennifer J.; Rudnick, Wallis; Mitchell, Robyn; Brooks, James; Bush, Kathryn; Conly, John; Ellison, Jennifer; Frenette, Charles; Johnston, Lynn; Lavallée, Christian; McGeer, Allison; Mertz, Dominik; Pelude, Linda; Science, Michelle; Simor, Andrew; Smith, Stephanie; Stagg, Paula; Suh, Kathryn N.; Thampi, Nisha; Thirion, Daniel J.G.; Vayalumkal, Joseph; Wong, Alice; Taylor, Geoffrey
• Other Names: collab.
• Is Part Of: Infection control and hospital epidemiology. Volume 43:Number 11(2022)
• Page Start: 1558
• Page End: 1564
• Publication Date: 2022-11-07
• Subjects: antimicrobial use -- point prevalence surveys -- hospital epidemiology -- healthcare-associated infections; Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2021.519
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract: Objectives: The Canadian Nosocomial Infection Surveillance Program conducted point-prevalence surveys in acute-care hospitals in 2002, 2009, and 2017 to identify trends in antimicrobial use. Methods: Eligible inpatients were identified from a 24-hour period in February of each survey year. Patients were eligible (1) if they were admitted for ≥48 hours or (2) if they had been admitted to the hospital within a month. Chart reviews were conducted. We calculated the prevalence of antimicrobial use as follows: patients receiving ≥1 antimicrobial during survey period per number of patients surveyed × 100%. Results: In each survey, 28−47 hospitals participated. In 2002, 2, 460 (36.5%; 95% CI, 35.3%−37.6%) of 6, 747 surveyed patients received ≥1 antimicrobial. In 2009, 3, 566 (40.1%, 95% CI, 39.0%−41.1%) of 8, 902 patients received ≥1 antimicrobial. In 2017, 3, 936 (39.6%, 95% CI, 38.7%−40.6%) of 9, 929 patients received ≥1 antimicrobial. Among patients who received ≥1 antimicrobial, penicillin use increased 36.8% between 2002 and 2017, and third-generation cephalosporin use increased from 13.9% to 18.1% ( P < .0001). Between 2002 and 2017, fluoroquinolone use decreased from 25.7% to 16.3% ( P < .0001) and clindamycin use decreased from 25.7% to 16.3% ( P < .0001) among patients who received ≥1 antimicrobial. Aminoglycoside use decreased from 8.8% to 2.4% ( P < .0001) and metronidazole use decreased from 18.1% to 9.4% ( P < .0001). Carbapenem use increased from 3.9% in 2002 to 6.1% in 2009 ( P < .0001) and increased by 4.8% between 2009 and 2017 ( P = .60). Conclusions: The prevalence of antimicrobial use increased between 2002 and 2009 and then stabilized between 2009 and 2017. These data provide important information for antimicrobial stewardship programs.