title: Relationship between consumption of MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia, Spain.
abstract: OBJECTIVE
  To analyse the possible relationship between consumption of old and new MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia during the period 2007-12.
  
  
  METHODS
  Fifty-four hospitals participating in the VINCat Programme were included. Proportion of MRSA (resistant isolates of Staphylococcus aureus per 100 isolates of S. aureus tested), incidence of new cases of infection [new cases of MRSA per 1000 occupied bed-days (OBD)] and incidence of cases of bacteraemia (MRSA bacteraemia cases per 1000 OBD) were determined to estimate the annual MRSA burden. Antibiotic consumption was calculated in DDD/100 OBD. Cost was expressed in euros/100 OBD.
  
  
  RESULTS
  MRSA rates remained stable over the study period, with the proportion of MRSA ranging from 20% to 22.82% in 2007 and 2012, respectively (P=0.864). Consumption of old MRSA-active antibiotics (vancomycin and teicoplanin) did not change significantly, with values from 1.51 to 2.07 DDD/100 OBD (P=0.693). Consumption of new MRSA-active antibiotics (linezolid and daptomycin) increased significantly, with values rising from 0.24 to 1.49 DDD/100 OBD (P<0.001). Cost increased by almost 200%.
  
  
  CONCLUSIONS
  A widespread and steady increase in consumption of new MRSA-active antibiotics was observed among acute care hospitals in Catalonia, in spite of a stable MRSA burden. At the same time, consumption of old drugs remained stable. Such trends resulted in a significant increase in cost. Our findings suggest that factors other than the proportion of methicillin resistance among S. aureus may influence the use of old and new MRSA-active antibiotics in the clinical setting.
authors.affiliation: Department of Pharmacy, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain sgrau@parcdesalutmar.cat.
authors.forename: Santiago
authors.initials: S
authors.lastname: Grau
authors.affiliation: VINCat Coordinating Centre, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Fondevilla
authors.affiliation: Infection Control and Prevention, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Freixas
authors.affiliation: Department of Biostatistics Assistance, IMIM, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Mojal
authors.affiliation: Infection Control, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Sopena
authors.affiliation: Infectious Diseases Unit, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.
authors.forename: Feliu
authors.initials: F
authors.lastname: Bella
authors.affiliation: Department of Infectious Disease, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Gudiol
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D004363:Drug Utilization; D006761:Hospitals; D006801:Humans; D015994:Incidence; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: MRSA; daptomycin; defined daily dose; linezolid; teicoplanin; vancomycin