Giuseppe
Emeritus
Appropriateness of antimicrobial therapy: a multicentre prevalence survey in the Netherlands, 2008?2009 (Euro Surveill., abstract, edited)
[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19715">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 15, Issue 46, 18 November 2010
Surveillance and outbreak reports
Appropriateness of antimicrobial therapy: a multicentre prevalence survey in the Netherlands, 2008?2009
I Willemsen 1, T van der Kooij 2, B van Benthem 2, J Wille 3, J Kluytmans 1,4
1. Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands
2. Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
3. Dutch Institute for Healthcare Improvement (CBO), Utrecht, the Netherlands
4. Department of Microbiology and Infection Control, VU University Medical Center (VU medisch centrum, VUmc), Amsterdam, the Netherlands
Citation style for this article: Willemsen I, van der Kooij T, van Benthem B, Wille J, Kluytmans J. Appropriateness of antimicrobial therapy: a multicentre prevalence survey in the Netherlands, 2008?2009. Euro Surveill. 2010;15(46)
ii=19715. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19715
Date of submission: 06 June 2010
A survey was carried out to determine the prevalence and appropriateness of antimicrobial therapy (AMT) in the Netherlands and to identify determinants for inappropriate AMT. Prevalence surveys of patients hospitalised in the Netherlands were performed three times in 2008 and 2009. Patients? demographic, infection-related and AMT-related data were collected from hospital wards. A total of 19 hospitals participated, consisting of a mix of university, teaching and general hospitals, which were distributed evenly across the country. The appropriateness of AMT was assessed using a standardised algorithm based on local AMT prescription guidelines. A total of 7,853 patients were included, of which 2,327 (29.6%) patients were on AMT (range: 20.8?39.5%). In 372 patients (16% of patients on AMT), treatment was considered inappropriate. In 265 (11.4%) patients on AMT, appropriateness of treatment was not judged because of insufficient information. The percentage of patients without a judgment varied considerably between the participating hospitals (range: 1.3?36.2%). Appropriate AMT use was significantly associated with a patient being in an intensive care unit, having a central venous catheter and being given beta-lactamase-sensitive penicillins. The use of fluoroquinolones was significantly associated with more frequent inappropriate use. There was considerable and significant variation between the participating hospitals in the amount of antimicrobials prescribed and the appropriateness of their use. To improve the completeness and reliability of such surveys, there is a need for intensive training of observers and medical staff in recording information.
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[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19715">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 15, Issue 46, 18 November 2010
Surveillance and outbreak reports
Appropriateness of antimicrobial therapy: a multicentre prevalence survey in the Netherlands, 2008?2009
I Willemsen 1, T van der Kooij 2, B van Benthem 2, J Wille 3, J Kluytmans 1,4
1. Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands
2. Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
3. Dutch Institute for Healthcare Improvement (CBO), Utrecht, the Netherlands
4. Department of Microbiology and Infection Control, VU University Medical Center (VU medisch centrum, VUmc), Amsterdam, the Netherlands
Citation style for this article: Willemsen I, van der Kooij T, van Benthem B, Wille J, Kluytmans J. Appropriateness of antimicrobial therapy: a multicentre prevalence survey in the Netherlands, 2008?2009. Euro Surveill. 2010;15(46)
ii=19715. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19715Date of submission: 06 June 2010
A survey was carried out to determine the prevalence and appropriateness of antimicrobial therapy (AMT) in the Netherlands and to identify determinants for inappropriate AMT. Prevalence surveys of patients hospitalised in the Netherlands were performed three times in 2008 and 2009. Patients? demographic, infection-related and AMT-related data were collected from hospital wards. A total of 19 hospitals participated, consisting of a mix of university, teaching and general hospitals, which were distributed evenly across the country. The appropriateness of AMT was assessed using a standardised algorithm based on local AMT prescription guidelines. A total of 7,853 patients were included, of which 2,327 (29.6%) patients were on AMT (range: 20.8?39.5%). In 372 patients (16% of patients on AMT), treatment was considered inappropriate. In 265 (11.4%) patients on AMT, appropriateness of treatment was not judged because of insufficient information. The percentage of patients without a judgment varied considerably between the participating hospitals (range: 1.3?36.2%). Appropriate AMT use was significantly associated with a patient being in an intensive care unit, having a central venous catheter and being given beta-lactamase-sensitive penicillins. The use of fluoroquinolones was significantly associated with more frequent inappropriate use. There was considerable and significant variation between the participating hospitals in the amount of antimicrobials prescribed and the appropriateness of their use. To improve the completeness and reliability of such surveys, there is a need for intensive training of observers and medical staff in recording information.
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