Update on glycopeptide use in german university hospitals.
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.
Kern
W V
WV
Division of Infectious Diseases, Dept. of Medicine, Freiburg University Hospital, Hugstetter Strasse 55, D-79106 Freiburg, Germany. kern@medizin.ukl.uni-freiburg.de
De With
K
K
Gonnermann
C
C
Strehl
E
E
Bergner
Jobst
J
Höffken
Gert
G
Dörje
Frank
F
Daschner
Frank
F
Steib-Bauert
Michaela
M
Haber
Manfred
M
Herrmann
Matthias
M
Hartmann
Michael
M
Straube
Eberhard
E
Bühner
Reinhard
R
Rothe
Ulrich
U
Salzberger
Bernd
B
Marre
Reinhard
R
Kern
Peter
P
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
D000900:Anti-Bacterial Agents; D006020:Glycopeptides