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Infection. 2014 Feb;42(1):119-25. doi: 10.1007/s15010-013-0531-y. Epub 2013 Oct 18.

Antibiotic stewardship in Germany: a cross-sectional questionnaire survey of 355 intensive care units.

Author information

1
Institute of Hygiene and Environmental Medicine, Charité Berlin, Hindenburgdamm 27, 12203, Berlin, Germany, friederike.maechler@charite.de.

Abstract

PURPOSE:

Little information is available on antibiotic prescription management in German hospitals. The objective of this cross-sectional study was to determine the prevalence and components of antibiotic stewardship measures in German intensive care units (ICUs).

METHODS:

A questionnaire survey was sent to all ICUs participating in the German nosocomial infection surveillance system (n = 579) in October 2011. Data on antibiotic management structures were collected and analyzed by structural hospital and ICU factors.

RESULTS:

The questionnaire was completed by 355 German ICUs (response rate 61 %). Common measures used (>80 % of the ICUs) were personnel restrictions for antibiotic prescriptions, routine access to bacterial resistance data, and pharmacy reports on antibiotic costs and consumption. A small proportion of ICUs (14 %) employed physicians specialized in the prescription of antimicrobial medication. Hospitals with their own microbiological laboratory report participation in surveillance networks for antimicrobial use (34 %) and bacterial resistance (32 %) twice as often as hospitals with external laboratories (15 and 14 %, respectively, p < 0.001). Also, non-profit and public hospitals participate more often in surveillance networks for bacterial resistance than private hospitals (>23 % vs. 11 %, p < 0.05).

CONCLUSIONS:

While the majority of ICUs report to have some antibiotic policies established, the contents and composition of these policies vary. Organizational-level control strategies to improve antibiotic management are common in Germany. However, strategies widely considered effective, such as the systematic cross-institutional surveillance of antimicrobial use and bacterial resistance in a standardized manner or the employment of infectious disease specialists, are scarce. This study provides a benchmark for future antibiotic stewardship programs.

PMID:
24135909
DOI:
10.1007/s15010-013-0531-y
[Indexed for MEDLINE]

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