Trends in antimicrobial consumption at 72 adult and pediatric hospitals in Catalonia. Results of the VINCat Program 2008–2022

Abstract

Introduction

Antimicrobial stewardship programs (ASPs) monitor antimicrobial consumption and implement interventions in order to improve their use. Here, we analyze the trends in antimicrobial consumption at hospitals participating in the VINCat Program over a 15-year period in Catalonia, Spain.

Methods

We conducted a time-series analysis of systemic antimicrobial consumption in both adult and pediatric populations across 72 acute care centers. The annual measurement of systemic antibiotic and antifungal use was conducted using defined daily dose (DDD) in adults and days of therapy (DOT) in children. To analyze trends in antimicrobial use, we considered the annual consumption defined in DDD or DOT per 100 patient-days.

Results

Overall adult consumption (2008–2022) of antimicrobials, antibiotics, and antifungals averaged 73.54, 70.08, and 3.46 DDD/100 patient-days respectively. There was a significant increase in overall antimicrobial (rho = 0.554; p = 0.035) and also in antifungal (rho = 0.657; p = 0.01) consumption during the study period. Antibiotic consumption showed an upward trend in the first period followed by an unchanged consumption in the following years (rho = 0.482; p = 0.071). Penicillins were the most frequently used (33.5%), followed by cephalosporins (18.2%), quinolones (13.9%), and other systemic antibacterials (10.8%) and antifungals (4.7%). Pediatric consumption was analyzed between 2020 and 2022. Overall, antimicrobial, antibiotic, and antifungal use in this population averaged 60.04, 53.47, and 6.57 DOT/100 patient-days respectively. As in adults, in children penicillins were the most used family (34.3%); within this group, penicillin combinations with beta-lactamase inhibitors (21.1%) were the most used, followed by cephalosporins (19.3%).

Conclusions

Participation on the VINCat Program was high at both adult and pediatric hospitals. Fifteen-year trends showed a significant increase in overall antimicrobial consumption in adults.