Antimicrobial use among adult inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program: 2009 to 2016

Rudnick, Wallis; Science, Michelle; Thirion, Daniel J. G.; Abdesselam, Kahina; Choi, Kelly B.; Pelude, Linda; Amaratunga, Kanchana; Comeau  Jeannette L .; Dalton, Bruce; Delport, Johan; Dhami, Rita; Embree, Joanne; Émond, Yannick; Evans, Gerald; Frenette, Charles; Fryters, Susan; German, Greg; Grant, Jennifer M.; Happe, Jennifer; Katz, Kevin; Kibsey, Pamela; Kosar, Justin; Langley, Joanne M.; Lee, Bonita E.; Lefebvre, Marie-Astrid; Leis, Jerome A.; McGeer, Allison; Neville, Heather L.; Simor, Andrew; Slayter, Kathryn; Suh, Kathryn N.; Tse-Chang, Alena; Weiss, Karl; Conly, John; Canadian Nosocomial Infection Surveillance Program

Antimicrobial use among adult inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program: 2009 to 2016

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creativework.keywords - en: Antimicrobial use; Hospital; Surveillance
dc.contributor.author: Rudnick, Wallis; Science, Michelle; Thirion, Daniel J. G.; Abdesselam, Kahina; Choi, Kelly B.; Pelude, Linda; Amaratunga, Kanchana; Comeau Jeannette L .; Dalton, Bruce; Delport, Johan; Dhami, Rita; Embree, Joanne; Émond, Yannick; Evans, Gerald; Frenette, Charles; Fryters, Susan; German, Greg; Grant, Jennifer M.; Happe, Jennifer; Katz, Kevin; Kibsey, Pamela; Kosar, Justin; Langley, Joanne M.; Lee, Bonita E.; Lefebvre, Marie-Astrid; Leis, Jerome A.; McGeer, Allison; Neville, Heather L.; Simor, Andrew; Slayter, Kathryn; Suh, Kathryn N.; Tse-Chang, Alena; Weiss, Karl; Conly, John; Canadian Nosocomial Infection Surveillance Program
dc.date.accessioned: 2023-06-01T15:34:03Z
dc.date.available: 2023-06-01T15:34:03Z
dc.date.issued: 2020-02-13
dc.description.abstract - en: Background: Antimicrobial resistance is a growing threat to the world's ability to prevent and treat infections. Links between quantitative antibiotic use and the emergence of bacterial resistance are well documented. This study presents benchmark antimicrobial use (AMU) rates for inpatient adult populations in acute-care hospitals across Canada. Methods: In this retrospective surveillance study, acute-care adult hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) submitted annual AMU data on all systemic antimicrobials from 2009 to 2016. Information specific to intensive care units (ICUs) and non-ICU wards were available for 2014-2016. Data were analyzed using defined daily doses (DDD) per 1000 patient days (DDD/1000pd). Results: Between 2009 and 2016, 16-18 CNISP adult hospitals participated each year and provided their AMU data (22 hospitals participated in ≥1 year of surveillance; 11 in all years). From 2009 to 2016, there was a significant reduction in use (12%) (from 654 to 573 DDD/1000pd, p = 0.03). Fluoroquinolones accounted for the majority of this decrease (47% reduction in combined oral and intravenous use, from 129 to 68 DDD/1000pd, p < 0.002). The top five antimicrobials used in 2016 were cefazolin (78 DDD/1000pd), piperacillin-tazobactam (53 DDD/1000pd), ceftriaxone (49 DDD/1000pd), vancomycin (combined oral and intravenous use was 44 DDD/1000pd; 7% of vancomycin use was oral), and ciprofloxacin (combined oral and intravenous use: 42 DDD/1000pd). Among the top 10 antimicrobials used in 2016, ciprofloxacin and metronidazole use decreased significantly between 2009 and 2016 by 46% (p = 0.002) and 26% (p = 0.002) respectively. Ceftriaxone (85% increase, p = 0.0008) and oral amoxicillin-clavulanate (140% increase, p < 0.0001) use increased significantly but contributed only a small component (8.6 and 5.0%, respectively) of overall use. Conclusions: This study represents the largest collection of dispensed antimicrobial use data among inpatients in Canada to date. Between 2009 and 2016, there was a significant 12% decrease in AMU, driven primarily by a 47% decrease in fluoroquinolone use. Modest absolute increases in parenteral ceftriaxone and oral amoxicillin-clavulanate use were noted but contributed a small amount of total AMU. Ongoing national surveillance is crucial for establishing benchmarks and antimicrobial stewardship guidelines.
dc.identifier.citation: Rudnick W, Science M, Thirion DJG, Abdesselam K, Choi KB, Pelude L, Amaratunga K, Comeau JL, Dalton B, Delport J, Dhami R, Embree J, Émond Y, Evans G, Frenette C, Fryters S, German G, Grant JM, Happe J, Katz K, Kibsey P, Kosar J, Langley JM, Lee BE, Lefebvre MA, Leis JA, McGeer A, Neville HL, Simor A, Slayter K, Suh KN, Tse-Chang A, Weiss K, Conly J; Canadian Nosocomial Infection Surveillance Program. Antimicrobial use among adult inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program: 2009 to 2016. Antimicrob Resist Infect Control. 2020 Feb 13;9(1):32. doi: 10.1186/s13756-020-0684-2.
dc.identifier.doi: https://doi.org/10.1186/s13756-020-0684-2
dc.identifier.uri: https://open-science.canada.ca/handle/123456789/497
dc.language.iso: en
dc.publisher: Springer Nature
dc.rights - en: Creative Commons Attribution 4.0 International (CC BY 4.0)
dc.rights - fr: Creative Commons Attribution 4.0 International (CC BY 4.0)
dc.rights.openaccesslevel - en: Gold
dc.rights.openaccesslevel - fr: Or
dc.rights.uri - en: https://creativecommons.org/licenses/by/4.0/
dc.rights.uri - fr: https://creativecommons.org/licenses/by/4.0/deed.fr
dc.subject - en: Health
dc.subject - fr: Santé
dc.subject.en - en: Health
dc.subject.fr - fr: Santé
dc.title - en: Antimicrobial use among adult inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program: 2009 to 2016
dc.type - en: Article
dc.type - fr: Article
local.article.journalissue: 1
local.article.journaltitle: Antimicrobial Resistance & Infection Control
local.article.journalvolume: 9
local.peerreview - en: Yes
local.peerreview - fr: Oui