title: Update on glycopeptide use in german university hospitals.
abstract: BACKGROUND
  A previous study has shown considerable variation in glycopeptide use from 1992 through 1994 among four university hospitals in southern Germany. Active antimicrobial management in one of the hospitals was associated with the containment of glycopeptide consumption in the medical and surgical service at < 1.5 defined daily doses (DDD)/100 patient days in the subsequent period. In the present study, more recent data on comparative glycopeptide use in German university hospitals were analyzed.
  
  
  METHODS
  Hospital pharmacy records from 1998 through 2000 were evaluated. The number of DDD (definition according to the World Health Organization [WHO]/Anatomic and Therapeutic Classification [ATC] index) per 100 patient days was calculated to compare glycopeptide use in different medical and surgical service areas between eight German university hospitals.
  
  
  RESULTS
  The 3-year averages in recent glycopeptide use for the eight hospitals ranged between 1.3 and 8.8 DDD/100 patient days in the medical services, and between 0.7 and 1.8 DDD/100 patient days in the surgical services. Only one of the eight hospitals showed medical service glycopeptide use of < 1.5 DDD/100 patient days. In most hospitals, glycopeptide use was higher in the medical intensive care units (ICU) (median 8.6; range 4.3 to 12 DDD/100 patient days, data for the year 2000) than in the surgical ICUs (median 6.7; range 1.2 to 8.6 DDD/100 patient days, data for the year 2000). High use was also observed for hematology-oncology services (median 7.5; range 2.7 to 15.7 DDD/100 patient days, data for the year 2000).
  
  
  CONCLUSIONS
  These recent data from a larger hospital sample confirm large variations in glycopeptide use, identify hematology-oncology services as a significant prescribing source along with ICUs, and indicate areas of probable overuse of glycopeptide antibiotics. The data may be useful as a benchmark for further focused drug use control interventions.
authors.affiliation: Division of Infectious Diseases, Dept. of Medicine, Freiburg University Hospital, Hugstetter Strasse 55, D-79106 Freiburg, Germany. kern@medizin.ukl.uni-freiburg.de
authors.forename: W V
authors.initials: WV
authors.lastname: Kern
authors.forename: K
authors.initials: K
authors.lastname: De With
authors.forename: C
authors.initials: C
authors.lastname: Gonnermann
authors.forename: E
authors.initials: E
authors.lastname: Strehl
authors.forename: Jobst
authors.initials: J
authors.lastname: Bergner
authors.forename: Gert
authors.initials: G
authors.lastname: Höffken
authors.forename: Frank
authors.initials: F
authors.lastname: Dörje
authors.forename: Frank
authors.initials: F
authors.lastname: Daschner
authors.forename: Michaela
authors.initials: M
authors.lastname: Steib-Bauert
authors.forename: Manfred
authors.initials: M
authors.lastname: Haber
authors.forename: Matthias
authors.initials: M
authors.lastname: Herrmann
authors.forename: Michael
authors.initials: M
authors.lastname: Hartmann
authors.forename: Eberhard
authors.initials: E
authors.lastname: Straube
authors.forename: Reinhard
authors.initials: R
authors.lastname: Bühner
authors.forename: Ulrich
authors.initials: U
authors.lastname: Rothe
authors.forename: Bernd
authors.initials: B
authors.lastname: Salzberger
authors.forename: Reinhard
authors.initials: R
authors.lastname: Marre
authors.forename: Peter
authors.initials: P
authors.lastname: Kern
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000517:prevention & control; D004363:Drug Utilization / Q000706:statistics & numerical data; D005858:Germany; D006020:Glycopeptides; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units
chemical_list: D000900:Anti-Bacterial Agents; D006020:Glycopeptides