This report encapsulates a pioneering investigation which scrutinized the current landscape of antimicrobial use among non-surgical inpatients in 25 general hospitals across Shanxi Province. The aim of this study was to assess the antimicrobial use rate, antimicrobial use density (AUD), the days of therapy (DOT), length of therapy (LOT), and to ascertain the utility of cluster analysis in the monitoring of antimicrobial prescribing practices.
The study commenced on December 1, 2022, and finalized on January 31, 2023, during which 2064 non-surgical patients, admitted in the aforementioned 25 general hospitals that spanned 11 cities in Shanxi Province, were analyzed for their antimicrobial use. A wide array of data was recorded encompassing the proportion of antimicrobial prescriptions, antimicrobial usage rate, AUD, DOT, and LOT.
The study employed IBM SPSS version 21.0 for statistical analyses and utilized cluster analysis for the systematic categorization of the studied hospitals. The results demonstrated a varying antimicrobial utilization rate, ranging from 43.00% to 83.33%, and intensity of use ranging from 40 DDDs/ 100pd to 98.99 DDDs/100pd. The DOT values lie between 380/1000pd to 713/1000pd, while LOT ranges from 425/1000pd to 1014/1000pd.
The classes of antimicrobials with the highest AUD were third-generation cephalosporins (15.38 DDDs/100pd), quinolones (13.60 DDDs/100pd), and cephalosporins (11.54 DDDs/100pd). The study also highlights the Intensive Care Unit (ICU), which had the highest antimicrobial use rate and AUD- 91.67% and 133.28 DDDs/100pd, respectively, along with the longest DOT (1230/1000 pd). The infection department reported the highest LOT (988/1000pd). In Pediatrics, the AUD and DOT were 53.77DDDs/ 100pd and 1106/1000pd, by respective.
Through the cluster analysis, the hospitals were systematically grouped into three distinctive clusters, showing statistically significant differences in few antimicrobial indicators (P < 0.05). The study concluded with the findings indicating a rather high rate and intensity of antimicrobial use in the selected institutions and departments, with a notable upsurge in the use of cefoperazone/sulbactam and fluoroquinolones during the study period. Cluster analysis here emerges as a valuable tool for identifying patterns in antimicrobial management and usage, complementing the use of AUD and DOT for a more comprehensive understanding of exposure levels across different hospitals and departments.
Source: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1464613/full