863 Variation in Antibiotic Use in Neonatal Intensive Care Units in the Netherlands

Abstract

Background and aims: Monitoring antibiotic use is essential to prevent overuse and misuse of antibiotics and to address the threat posed by resistant microorganisms. Studies have shown great variability in use of antibiotics between Dutch and European hospitals. Since empiric antibiotic therapy differs between NICUs and there is no consensus on the choice of antibiotics, we examined the variation in quantity and classes of antibiotics used in all ten tertiary care neonatal intensive care units (NICUs) in the Netherlands during 2005. Methods: We collected data from all tertiary care NICUs in the Netherlands on clinical and demographic characteristics and the type and quantity of systemic antibiotic use (expressed as Defined Daily Doses (DDD)/100 admissions) in 2005. Antibiotics were ranked by volume of DDDs, and those antibiotics which accounted for 90% of the total volume of use (Drug Utilization (DU) 90%) were noted. Treatment guidelines on antibiotic policy were investigated. Results: Antibiotic consumption (based on pharmacy dispensing data) ranged from 130 to 360 DDD/100 admissions. In total 9-24 different antibiotics were used, of which 3-10 were in the DU90%-segment. The number of used antibiotics that were mentioned in the treatment guidelines ranged from 4 (25%) to 10 (77%) antibiotics. Conclusions: By comparing antibiotic use in Dutch NICUs we found a considerable variation in the number of different antibiotics used and in the total amount of antibiotic use. Exploration of the opportunities to reach consensus in antibiotic policy, and to increase attention to antibiotic stewardship, is recommended.