Prevalence and Shifts in Antibiotic Use in an Italian Hospital: A Comparison of 2016 and 2022 Data

BACKGROUND: Antibiotics are among the most commonly prescribed drugs, but inappropriate prescription rates (molecule, duration or dosage) remain high, leading to the selection of multidrug-resistant microorganisms. This study aims to describe the most commonly used antibiotics in our hospital and compare them to 2016 data. METHODS: Conducted in November 2022 at the Azienda Ospedaliera Universitaria delle Marche of Ancona (Italy), the study followed the protocol proposed by the European Center for Disease Prevention and Control (ECDC). Patients admitted to wards before 8 a.m. and not discharged at the time of the survey were included. Data from 2022 were compared to the 2016 study. RESULTS: In 2022, 41.7% (N = 284) of the 681 patients were taking at least one antibiotic, with 400 antibiotic therapies administered, of which 90.5% were given parenterally. Among the patients on antimicrobial therapy, 40% were being treated for a community infection, 27% for a hospital acquired infection and 19% for surgical prophylaxis. Among all the antimicrobial prescriptions used, the most used class of antibiotics in 2022 was penicillin / beta lactamase inhibitor (21.6%, N = 86), followed by third-generation cephalosporins (11.8%, N = 47), carbapenems (11.6%, N = 46), glycopeptides (8.8%, N = 35), first-generation cephalosporins (8.8%, N = 35) and fluoroquinolones (7.0%, N = 28). Data from 2016 registered a 21.2% prevalence of penicillin / beta lactamase inhibitor, 15.7% of fluoroquinolones, 14.7% of third-generation cephalosporins, 10.5% first-generation cephalosporins, 7.6% of carbapenems and 4.1% of glycopeptides. CONCLUSIONS: The prevalence of antibiotics used in our hospital has changed after six years. This shift may be due to new patterns of bacterial resistance and new antimicrobial drugs (e.g. cefiderocol). KEY MESSAGES: • Our study found a shift in prevalence of antibiotic use in our hospital after six years. • Penicillin/beta lactamase inhibitors are still the most commonly used antibiotics in our hospital.