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Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis

This ecological study is the largest to date examining the association between rates of antibiotic use (AU) and hospital-onset (HO) Clostridioides difficile infection (CDI) in a tertiary university hospital in Serbia. There was no clear trend in the incidence of HO-CDI over time. Total utilization o...

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Autores principales: Perić, Aneta, Rančić, Nemanja, Dragojević-Simić, Viktorija, Milenković, Bojana, Ljubenović, Nenad, Rakonjac, Bojan, Begović-Kuprešanin, Vesna, Šuljagić, Vesna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495030/
https://www.ncbi.nlm.nih.gov/pubmed/36139957
http://dx.doi.org/10.3390/antibiotics11091178
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author Perić, Aneta
Rančić, Nemanja
Dragojević-Simić, Viktorija
Milenković, Bojana
Ljubenović, Nenad
Rakonjac, Bojan
Begović-Kuprešanin, Vesna
Šuljagić, Vesna
author_facet Perić, Aneta
Rančić, Nemanja
Dragojević-Simić, Viktorija
Milenković, Bojana
Ljubenović, Nenad
Rakonjac, Bojan
Begović-Kuprešanin, Vesna
Šuljagić, Vesna
author_sort Perić, Aneta
collection PubMed
description This ecological study is the largest to date examining the association between rates of antibiotic use (AU) and hospital-onset (HO) Clostridioides difficile infection (CDI) in a tertiary university hospital in Serbia. There was no clear trend in the incidence of HO-CDI over time. Total utilization of antibacterials for systemic use increased from 38.57 DDD/100 bed-days (BD) in 2011 to 56.39 DDD/100 BD in 2021. The most commonly used antibiotics were third-generation cephalosporins, especially ceftriaxone, with maximum consumption in 2021 (19.14 DDD/100 BD). The share of the Access group in the total utilization of antibiotics ranged from 29.95% to 42.96% during the observed period. The utilization of the Reserve group of antibiotics indicated a statistically significant increasing trend (p = 0.034). A statistically significant difference in the consumption of medium-risk antibiotics from 2011 to 2021 was shown for penicillins and a combination of sulfamethoxazole and trimethoprim. The consumption of cefotaxime showed a statistically significant negative association with the rate of HO-CDI (r = −0.647; p = 0.031). Ampicillin and the combination of amoxicilline with clavulanic acid have shown a negative statistically significant correlation with the ID of HO-CDI (r = −0.773 and r = −0.821, respectively). Moreover, there was a statistically significant negative correlation between consumption of “medium-risk antibiotics” and the rate of HO-CDI (r = −0.677). The next challenging step for the hospital multidisciplinary team for antimicrobials is to modify the antibiotic list according to the Access, Watch, and Reserve classification, in such a way that at least 60% of the AU should be from the Access group, according to the World Health Organization recommendation.
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spelling pubmed-94950302022-09-23 Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis Perić, Aneta Rančić, Nemanja Dragojević-Simić, Viktorija Milenković, Bojana Ljubenović, Nenad Rakonjac, Bojan Begović-Kuprešanin, Vesna Šuljagić, Vesna Antibiotics (Basel) Article This ecological study is the largest to date examining the association between rates of antibiotic use (AU) and hospital-onset (HO) Clostridioides difficile infection (CDI) in a tertiary university hospital in Serbia. There was no clear trend in the incidence of HO-CDI over time. Total utilization of antibacterials for systemic use increased from 38.57 DDD/100 bed-days (BD) in 2011 to 56.39 DDD/100 BD in 2021. The most commonly used antibiotics were third-generation cephalosporins, especially ceftriaxone, with maximum consumption in 2021 (19.14 DDD/100 BD). The share of the Access group in the total utilization of antibiotics ranged from 29.95% to 42.96% during the observed period. The utilization of the Reserve group of antibiotics indicated a statistically significant increasing trend (p = 0.034). A statistically significant difference in the consumption of medium-risk antibiotics from 2011 to 2021 was shown for penicillins and a combination of sulfamethoxazole and trimethoprim. The consumption of cefotaxime showed a statistically significant negative association with the rate of HO-CDI (r = −0.647; p = 0.031). Ampicillin and the combination of amoxicilline with clavulanic acid have shown a negative statistically significant correlation with the ID of HO-CDI (r = −0.773 and r = −0.821, respectively). Moreover, there was a statistically significant negative correlation between consumption of “medium-risk antibiotics” and the rate of HO-CDI (r = −0.677). The next challenging step for the hospital multidisciplinary team for antimicrobials is to modify the antibiotic list according to the Access, Watch, and Reserve classification, in such a way that at least 60% of the AU should be from the Access group, according to the World Health Organization recommendation. MDPI 2022-08-31 /pmc/articles/PMC9495030/ /pubmed/36139957 http://dx.doi.org/10.3390/antibiotics11091178 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Perić, Aneta
Rančić, Nemanja
Dragojević-Simić, Viktorija
Milenković, Bojana
Ljubenović, Nenad
Rakonjac, Bojan
Begović-Kuprešanin, Vesna
Šuljagić, Vesna
Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis
title Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis
title_full Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis
title_fullStr Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis
title_full_unstemmed Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis
title_short Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in University Tertiary Hospital in Serbia, 2011–2021: An Ecological Analysis
title_sort association between antibiotic use and hospital-onset clostridioides difficile infection in university tertiary hospital in serbia, 2011–2021: an ecological analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495030/
https://www.ncbi.nlm.nih.gov/pubmed/36139957
http://dx.doi.org/10.3390/antibiotics11091178
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