Redundant Anaerobic Antimicrobial Prescriptions in German Acute Care Hospitals: Data from a National Point Prevalence Survey

• Main Authors: Seven Johannes Sam Aghdassi, Petra Gastmeier, Michael Behnke, Sonja Hansen, Tobias Siegfried Kramer
• Format: Article
• Language: English
• Published: MDPI AG 2020-05-01
• Series: Antibiotics
• Subjects: antimicrobial stewardship; anaerobic spectrum; antimicrobial overuse; point prevalence survey; Germany
• Online Access: https://www.mdpi.com/2079-6382/9/6/288

Despite limited indications, redundant anaerobic antimicrobial prescriptions (RAAPs) are frequent. The objective of this study was to assess the prevalence and characteristics of RAAPs in German acute care hospitals.<b> </b>In a retrospective data analysis, antimicrobial prescriptions from a point prevalence survey on antimicrobial use in German acute care hospitals in 2016 were analyzed and RAAPs were identified. RAAPs were defined as a patient simultaneously receiving any of the following combinations: Penicillin/beta-lactamase inhibitor (PenBLI) plus clindamycin; PenBLI plus metronidazole; PenBLI plus moxifloxacin; PenBLI plus carbapenem; carbapenem plus clindamycin; carbapenem plus metronidazole; carbapenem plus moxifloxacin; clindamycin plus metronidazole; clindamycin plus moxifloxacin; and metronidazole plus moxifloxacin.<b> </b>Data from 64,412 patients in 218 hospitals were included. Overall, 4486 patients (7%) received two or more antimicrobials. In total, 441 RAAP combinations were identified. PenBLI plus metronidazole was the most common anaerobic combination (<i>N </i>=<i> </i>166, 38%). The majority of RAAPs were for the treatment of community-acquired (<i>N </i>=<i> </i>258, 59%) infections. Lower respiratory tract infections (<i>N </i>=<i> </i>77; 20%) and skin/soft tissue infections (<i>N </i>=<i> </i>76; 20%) were the most frequently recorded types of infections.<b> </b>RAAPs are common in German hospitals. Reducing redundant antimicrobial coverage should be a key component of future antimicrobial stewardship activities.