title: Repeated nationwide point-prevalence surveys of antimicrobial use in Swedish hospitals: data for actions 2003-2010.
abstract: This study sought to analyse antimicrobial pressure, indications for treatment, and compliance with treatment recommendations and to identify possible problem areas where inappropriate use could be improved through interventions by the network of the local Swedish Strategic Programme Against Antibiotic Resistance (Strama) groups. Five point-prevalence surveys were performed in between 49 and 72 participating hospitals from 2003 to 2010. Treatments were recorded for 19 predefined diagnosis groups and whether they were for community-acquired infection, hospital-acquired infection, or prophylaxis. Approximately one-third of inpatients were treated with antimicrobials. Compliance with guidelines for treatment of community-acquired pneumonia with narrow-spectrum penicillin was 17.0% during baseline 2003-2004, and significantly improved to 24.2% in 2010. Corresponding figures for quinolone use in uncomplicated cystitis in women were 28.5% in 2003-2004, and significantly improved, decreasing to 15.3% in 2010. The length of surgical prophylaxis improved significantly when data for a single dose and 1 day were combined, from 56.3% in 2003-2004 to 66.6% in 2010. Improved compliance was possibly the effect of active local feedback, repeated surveys, and increasing awareness of antimicrobial resistance. Strama groups are important for successful local implementation of antimicrobial stewardship programs in Sweden.
authors.affiliation: Public Health Agency of Sweden, Solna, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Skoog
authors.forename: Johan
authors.initials: J
authors.lastname: Struwe
authors.forename: Otto
authors.initials: O
authors.lastname: Cars
authors.forename: Håkan
authors.initials: H
authors.lastname: Hanberger
authors.forename: Inga
authors.initials: I
authors.lastname: Odenholt
authors.forename: Mårten
authors.initials: M
authors.lastname: Prag
authors.forename: Katarina
authors.initials: K
authors.lastname: Skärlund
authors.forename: Peter
authors.initials: P
authors.lastname: Ulleryd
authors.forename: Mats
authors.initials: M
authors.lastname: Erntell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology*; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Strama; antibiotic use; antimicrobial stewardship; community-acquired infection; healthcare-associated infections; surgical prophylaxis