Glycopeptide Use at Four University Hospitals in Southern Germany

Abstract

Glycopeptide use differs considerably at tertiary care hospitals in southern Germany, but use of < 1.5 DDD/100 patient days in both surgical as well as medical tertiary care hospital departments appears achievable.

Update on Glycopeptide Use in German University Hospitals

“…This is similar to rates reported in United States hospitals, despite considerably lower rates of oxacillin resistance in S. aureus in Germany [37,38].Active antimicrobial management in one of the hospitals included in our previous study was associated with decreasing glycopeptide consumption in the medical service to < 1.5 DDD/100 patient days. Our study also found this hospital had an essentially unchanged low consumption (< 1 DDD/100 patient days) in the surgical service area.…”

“…The hospitals varied in size from ~1,000 to ~1,700 beds, and differed from each other in structure, special services offered, and in the availability of interdepartmental guidelines and an antimicrobial therapeutics committee, antimicrobial drug formularies, formulary restrictions, and infectious disease consultation services. Two of the hospitals (A and B) had previously been included in drug utilization surveillance studies [37,38] so that a comparison of glycopeptide use was possible for the periods 1992-1994 vs 1998-2000. Both of these hospitals had a moderately active antibiotic management program, according to the definition used by Carling et al [40].…”

Epidemiology and Clinical Impact of Glycopeptide Resistance in Staphylococcus aureus

“…In a 3-year survey of eight German university hospitals, performed between 1998 and 2000, Kern et al [67] registered an average glycopeptide use ranging between 1.3 and 8.8 DDD/100 patient days on medical wards, whereas the corresponding use on surgical wards ranged between 0.7 and 1.8 DDD/100 patient days. Compared to an earlier survey [68], which was performed in four of these hospitals, glycopeptide use on surgical wards was lower in some hospitals, probably as a result of an active antibiotic management program. Glycopeptide use was markedly higher in intensive care units and hematology-oncology units, ranging up to 15.7 DDD/100 [70].…”

A 3 year survey on the use of antibacterial agents in five Italian hospitals

“…A study of glycopeptide use in German hospitals showed high consumption in the ICUs with a sharp increase in the period 1998 -2000. 13,14 The authors suggested that prophylactic and empirical indications may therefore account for more than 50% of all prescriptions, so that a substantial amount of glycopeptide prescriptions may be inappropriate. Irrespective of the reasons for such high consumption of glycopeptides, this is a matter of great concern because their excessive use enhances the risk of resistance among enterococci and staphylococci.…”