Antibiotic consumption in the Latvian teaching hospital 2000-2008

Antibiotics are one of the most commonly used drugs in hospital care and significantly contribute to healthcare costs. Recently, there has been significant interest raised on the environmental impact of antibiotic use, in particular on how it effects resistance selection pressure. Rapid global spread of multiresistant bacteria requires improved understanding on how changes in antibiotic use affect resistance selection. We present a unique study on antibiotic consumption and its trends over an eight-year period. Data were obtained from the pharmaceutical database system. The study period extended from January 2000 through December 2008. Antibiotic use was expressed as a rate - defined daily doses (DDD) per 100 patient days (DDD/100) in a quarter year. The total amount of antibiotics used for systemic treatment at the beginning of the period (first quarter of 2000) was 38.7 DDD per 100 bed days and increased to 72.6 DDD per 100 bed days (r = 0.81) by the 4^th quarter of 2008. Despite variability during the study period, a significant trend was observed with an average increase of 0.97 (95% CI: 1.2; 3.2) per quarter. Penicillin was the most common antibiotic group used at the hospital in the study period and demonstrated the greatest increase in consumption (r = 0.92). The consumption rates of fluoroquinolones were high and also showed a significant increase (r = 0.76). We observed a significant increase of antibiotic consumption in our hospital during the study period, which lacked a clear explanation. This increase was mostly due to increased use of amoxicillinum/enzyme inhibitor and ceftriaxone. Analysis of consumption should be continued to assess the impact of educational interventions.