title: Antibiotic usage in south-western French hospitals: trends and association with antibiotic stewardship measures.
abstract: OBJECTIVE
  French hospitals are urged by health authorities to develop antibiotic stewardship (ABS) programmes in order to improve antibiotic use and to decrease their consumption. We performed a longitudinal survey to describe ABS measures implementation and antibiotic use and to study relationships between ABS measures and trends in antibiotic use between 2005 and 2009.
  
  
  METHODS
  Data on ABS, antibiotic use and activity were retrospectively collected by questionnaires sent to hospitals voluntarily participating in the south-western France network. ABS measures covered organization, resources, restrictive and persuasive actions. Antibiotic use was retrieved from pharmacy records and expressed as the number of defined daily doses/1000 patient-days according to national and WHO guidelines using 2009 defined daily dose values to monitor trends. Relationships between ABS measures and antibiotic use were studied by multivariate logistic regression.
  
  
  RESULTS
  Between 2005 and 2009, the degree of implementation of ABS increased in the 74 participating hospitals. Antibiotic use remained stable, with variations according to hospital groups and antibiotic classes. In hospitals with more ABS measures, antibiotic use in general and fluoroquinolone use tended to remain stable or to decrease. Educational activities were associated with a decrease in fluoroquinolone use in the univariate analysis. In the multivariate analysis, practice audits and time dedicated by the antibiotic advisor were significantly associated with a decrease in total antibiotic use and fluoroquinolone use, respectively.
  
  
  CONCLUSIONS
  This first longitudinal study, in 74 hospitals, showed that human resources and persuasive ABS measures, in the context of a multidisciplinary approach, are helpful in controlling total antibiotic and fluoroquinolone use.
authors.affiliation: Univ. de Bordeaux, U657, F-33000 Bordeaux, France. catherine.dumartin@chu-bordeaux.fr
authors.forename: Catherine
authors.initials: C
authors.lastname: Dumartin
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Rogues
authors.forename: Brice
authors.initials: B
authors.lastname: Amadéo
authors.forename: Muriel
authors.initials: M
authors.lastname: Péfau
authors.forename: Anne-Gaëlle
authors.initials: AG
authors.lastname: Venier
authors.forename: Pierre
authors.initials: P
authors.lastname: Parneix
authors.forename: Catherine
authors.initials: C
authors.lastname: Maurain
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000592:standards* / Q000706:statistics & numerical data*; D005602:France; D006761:Hospitals; D006801:Humans; D008137:Longitudinal Studies; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents