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Hospitals Up Broad Spectrum Antibiotic Use, But Hold Steady Overall

ATLANTA – Use of broad spectrum antibiotics increased in U.S. hospitals from 2006-2012, even while overall rates of antibiotic use remained relatively unchanged.

That’s according to a new report published online by JAMA Internal Medicine. The article notes that ensuring appropriate antibiotic use in the United States is a national priority because of the threat of antibiotic resistance and other consequences when the drugs are used unnecessarily.

The study, led by CDC researchers, used proprietary administrative data from the Truven Health MarketScan Hospital Drug Database, which included about 300 hospitals and more than 34 million discharges, to estimate inpatient use of antibiotics.

Results indicate that, from 2006 through 2012, 55.1% of patients received at least one dose of antibiotics during a hospital stay. That translates into overall national days of therapy (DOT) of 755 per 1,000 patient-days, an increase of about 5.6, according to the report.

That does not represent a significant change in overall use over time, according to the authors. On the other hand, they expressed alarm at the increase in use of some power antibiotic classes:

  • third- and fourth-generation cephalosporins, 10.3;
  • glycopeptides, 22.4;
  • β-lactam/β-lactamase inhibitor combinations, 18.0;
  • carbapenems, 7.4;
  • tetracyclines, 3.3%; and
  • macrolides, 4.8%.

“This trend is worrisome in light of the rising challenge of antibiotic resistance,” the study authors concluded. “Our findings can help inform national efforts to improve antibiotic use by suggesting key targets for improvement interventions.”

Although prescribing antibiotics remains common and the use of the most powerful antibiotics is on the rise, studies have unveiled a number of important opportunities for hospitals to improve antibiotic use.

“We are committed to combatting antibiotic resistance by ensuring that every hospital in America has an active antibiotic stewardship program so that every patient gets the best possible treatment for their condition,” said Arjun Srinivasan, MD, of the U.S. Public Health Service, Associate Director for CDC’s Healthcare-Associated Infection Prevention Programs.

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