Longitudinal trends and cross-sectional analysis of English national hospital antibacterial use over 5 years (2008-13): working towards hospital prescribing quality measures

Cooke, Jonathan, Stephens, Peter, Ashiru-Oredope, Diane, Charani, Esmita, Dryden, Mathew, Fry, Carole, Hand, Kieran, Holmes, Alison, Howard, Philip, Johnson, Alan P, Livermore, David M ORCID: https://orcid.org/0000-0002-9856-3703, Mansell, Paula, McNulty, Cliodna A M, Wellsteed, Sally, Hopkins, Susan and Sharland, Mike (2015) Longitudinal trends and cross-sectional analysis of English national hospital antibacterial use over 5 years (2008-13): working towards hospital prescribing quality measures. Journal of Antimicrobial Chemotherapy, 70 (1). pp. 279-285. ISSN 0305-7453

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Abstract

OBJECTIVES: There is global concern that antimicrobial resistance is a major threat to healthcare. Antimicrobial use is a primary driver of resistance but little information exists about the variation in antimicrobial use in individual hospitals in England over time or comparative use between hospitals. The objective of this study was to collate, analyse and report issue data from pharmacy records of 158 National Health Service (NHS) acute hospitals.  METHODS: This was a cohort study of inpatient antibacterial use in acute hospitals in England analysed over 5 years through a data warehouse from IMS Health, a leading provider of information, services and technology for the healthcare industry. Around 98% of NHS hospitals were included in a country with a population of 50 million residents.  RESULTS: There was a dramatic change in the usage of different groups of antibacterials between 2009 and 2013 with a marked reduction in the use of first-generation cephalosporins by 24.7% and second-generation cephalosporins by 41%, but little change in the use of third-generation cephalosporins (+5.7%) and fluoroquinolones (+1.6%). In contrast, use of co-amoxiclav, carbapenems and piperacillin/tazobactam increased by 60.1%, 61.4% and 94.8%, respectively. There was wide variation in the total and relative amounts of antibacterials used between individual hospitals.  CONCLUSIONS: Longitudinal analysis of antibacterial use demonstrated remarkable changes in NHS hospitals, probably reflecting governmental and professional guidance to mitigate the risk of Clostridium difficile infection. The wide variation in usage between individual hospitals suggests potential for quality improvement and benchmarking. Quality measures of optimal hospital antimicrobial prescribing need urgent development and validation to support antimicrobial stewardship initiatives.

Item Type:	Article
Additional Information:	© The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
Uncontrolled Keywords:	therapeutic use,cohort studies,cross-sectional studies,drug utilization,england,health policy,health services research,hospitals,longitudinal studies,standards,quality control,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Depositing User:	LivePure Connector
Date Deposited:	24 Oct 2018 09:30
Last Modified:	21 Oct 2022 20:32
URI:	https://ueaeprints.uea.ac.uk/id/eprint/68614
DOI:	10.1093/jac/dku328

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