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

Results: Antibiotic consumption increased by 18% in the 3 year period. Combinations of penicillins and b-lactamase inhibitors were the most used drugs, followed by fluoroquinolones and thirdgeneration cephalosporins. Penicillins plus b-lactamase inhibitors increased in all the clinical areas by over 40%, and fluoroquinolones sharply increased in medical units (129%). Third-generation cephalosporins remained fairly stable in paediatrics and surgery, but increased in medicine (118%). Glycopeptides accounted for 4.3% of total antibiotic consumption with a peak of 10% in intensive care units. Antibacterial prescription in primary care showed a pattern similar to that of hospitals. Conclusions: We found a considerable increase in antibiotic use over time and a marked preference for wide-spectrum antibiotics such as penicillins plus b-lactamase inhibitors, fluoroquinolones and third-generation cephalosporins; thus raising concern about appropriate use. These results could represent the basis for educational initiatives aimed at rationalizing the use of antibiotics in hospitals.