Exploration de l’évolution de la consommation d’antibiotiques d’un centre hospitalier universitaire mère-enfant selon la classification AWaRe de l’Organisation mondiale de la santé

Abstract

Different measures of antimicrobial are used to ensure proper usage, as part of structured antimicrobial stewardship programs. The main objective of this study is to describe the consumption of antibiotics in a mother-child teaching hospital using the AWaRe classification over a period of 15 years. This descriptive and retrospective study included all the data on antibiotic consumption of patients admitted to mother-child University Hospital from April 1st 2005 to March 31st, 2021. Of the 180 international non-proprietary names of antibiotics proposed by the World Health Organization (WHO), 54 were used. The number of days of treatment (DOT) per 1000 patient-days (PD) was calculated per year, per patientele (e.g. surgery, pediatrics, oncology, intensive care, neonatal intensive care, nursery, psychiatry, rehabilitation and obstetrics and gynecology) and globally. The data was classified per the WHO AWaRe classification. A total of 10,489 DOT/1000PD were used globally in 15 years, corresponding to 53.9% of the "Access" group, 45.2% of the "Watch" group and 0.9% of the "Reserve" group. A reduction in the use of antibiotics was noted. The ratios of antibiotic consumptions in DOT/1000PD of 2020-2021 to 2005-2006 were 0.84 globally (1713/5653), 0.79 for the "Access" group (286/361), 0.89 for the "Watch" group (270/302) and 0.88 for the "Reserve" group (2.1/2.4). The AWaRe classification was used to describe the consumption of antibiotics in a mother-child center. Our consumption compared favorably with international data and is in line with the WHO targets. This position may be linked to the presence of a structured anti-biogovernance program that has been in place for several years within our hospital. More work is needed to more precisely identify the antibiotics that should benefit from better supervision.