Antimicrobial use in European acute care hospitals: results from the second point prevalence survey (PPS) of healthcare-associated infections and antimicrobial use, 2016 to 2017

Euro Surveill. 2018 Nov;23(46):1800393. doi: 10.2807/1560-7917.ES.23.46.1800393.

Abstract

Antimicrobial agents used to treat infections are life-saving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016-17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2-31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials.

Keywords: antibiotic use; antimicrobial use; healthcare-associated infections; hospitals; point-prevalence survey; surveillance.

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology
  • Drug Prescriptions / statistics & numerical data*
  • Drug Utilization / statistics & numerical data*
  • Female
  • Hospitals / statistics & numerical data*
  • Humans
  • Intensive Care Units
  • Male
  • Penicillins / therapeutic use
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology
  • Surveys and Questionnaires
  • beta-Lactamase Inhibitors / therapeutic use

Substances

  • Anti-Infective Agents
  • Penicillins
  • beta-Lactamase Inhibitors