[Surveillance of antibiotic consumption- a new task for public health services : Data from Frankfurt's hospitals between 2012 and 2014].
BACKGROUND
Given the increase of antibiotic resistant bacteria the requirement for hospitals and ambulatory services to collect and analyze antibiotic consumption data was stipulated in the Protection against Infection Act (IfSG) in 2011. It is the duty of the public health offices to supervise the compliance with these specifications. Below, the antibiotic consumption data of all hospitals in Frankfurt am Main between 2012 and 2014 are reported and the supervisory activities presented.


METHODS
Hospitals collect the antibiotic consumption data according to the legal requirements and provide the data in the form of defined daily doses (DDD) per active substance as suggested in the recommendations for the implementation of the law by the Robert Koch-Institute. Given the number of patient days the DDD/100 patient days could be calculated allowing a comparison between the hospitals. In 2015 the public health office additionally collected organizational and structural data on antimicrobial consumption.


RESULTS
With more than 1.5 million patient days per year and over a million DDD, the consumption in the year 2012 was 67.5 DDD/100 patient days (pt days) and 66.0 DDD/100 pt days in the year 2014, with a range of 26.4 to 86.7 DDD/100 pt days in the individual hospitals. In 2012 Cefuroxim made up for 24 % of total consumption with 256,343 DDD, followed by Ciprofloxacin, Ceftriaxon and Levofloxacin with over 6 % each and with no significant changes from 2012 through 2014. In 2012 the carbapenems were the fourth most frequently prescribed group of antibiotics with 65,772 DDD or 4.1 DDD/100 pt days after the cephalosporins (408,519 DDD; 25.7 DDD/100 pt days), penicillins (215,591 DDD; 13.5 DDD/100 pt days) and the fluoroquinolones (144,195 DD; 9.1 DDD/100 pt days). However, the consumption of carbapenems increased up to 2014 by 24 % to 82,007 DDD. All 16 hospitals had established an antibiotic consumption surveillance system including the evaluation of the data, however, the availability for the entire staff was not yet fully implemented.


CONCLUSIONS
This is the first report of antibiotic consumption data from the hospitals of an entire city. After compilation and processing of the data the public health office fed back this information to the facilities during on-site visits in 2015 - in an anonymized comparison with other hospitals of the region. This forces the hospitals to deal intensely with the data, with the goal of using antibiotics more appropriately in order to minimize the selective pressure due to mis- and overuse of antibiotics. The forthcoming years will clarify the effect of the antibiotic surveillance on antibiotic consumption in these hospitals.
Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland. ursel.heudorf@stadt-frankfurt.de.
Ursel
U
Heudorf
Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt, Deutschland.
Angelika
A
Hausemann
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006761:Hospitals / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods*
D000900:Anti-Bacterial Agents
Antibiotic consumption surveillance; Antibiotic resistance; Antibiotics; Hospitals; Public health office