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TitleAntimicrobial use in Australian Hospitals: 2014 report of the National Antimicrobial Utilisation ...
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Table of Contents
                            Foreword
Contents
Abbreviations
Executive summary
Introduction
Methods
	Contributing hospitals
	Units of measurement
	Data quality
	Data exclusions
	Data classification, restrictions and limitations
Overview of antimicrobial usage rates, 2014
	Total-hospital annual antimicrobial usage rates
	Top 20 antibacterials
	Comparison of usage rates by state
	Intrastate usage rates
Annual usage rates by antimicrobial class, 2010–2014
	Total-hospital usage rates for antibacterial classes
Antimicrobial usage rates by individual agent, 2014
	Aminoglycosides – amikacin, gentamicin, tobramycin
	Carbapenems – doripenem, ertapenem, imipenem, meropenem
	Third- and fourth-generation cephalosporins – ceftriaxone, cefotaxime, ceftazidime, cefepime
	Fluoroquinolones – ciprofloxacin, norfloxacin, moxifloxacin
	Glycopeptides – vancomycin, teicoplanin
	Macrolides – azithromycin, clarithromycin, erythromycin, roxithromycin
	Penicillins – penicillin/ß-lactamase inhibitor combinations: ticarcillin with clavulanate, piperacillin with tazobactam, amoxycillin with clavulanic acid
	Reserve-line agents – colistin, daptomycin, linezolid, tigecycline
Analysis of antibacterial usage by peer group
	Aminoglycosides
	Carbapenems
	Third- and fourth-generation cephalosporins – ceftriaxone, cefotaxime, ceftazidime, cefepime
	Fluoroquinolones – ciprofloxacin, norfloxacin, moxifloxacin
	Glycopeptides – vancomycin, teicoplanin
	Macrolides – azithromycin, clarithromycin, erythromycin, roxithromycin
	Penicillins –antipseudomonal penicillin/ß-lactamase inhibitor combinations: ticarcillin with clavulanate, piperacillin with tazobactam
	Reserve-line agents – colistin, daptomycin, linezolid
Benchmarking with other antimicrobial usage data
	International total-hospital usage rates
Discussion
Acknowledgments
Appendix 1	
Contributor information
Appendix 2		Definitions
Appendix 3	
WHO defined daily doses for antibacterial agents included in NAUSP annual report
Glossary
References
                        
Document Text Contents
Page 1

Antimicrobial use in
Australian hospitals
2014 repor t
o f the
Nat iona l Ant imicrob ia l Ut i l i sat ion
Surve i l l ance Program

Page 2

© Commonwealth of Australia 2015

Antimicrobial use in Australian hospitals: 2014 annual report of the National Antimicrobial Utilisation Surveillance Program

ISBN 978-1-925224-12-2 (print), 978-1-925224-14-6 (online)

This annual report was prepared by:

Infection Control Service
Communicable Disease Control Branch
SA Department for Health and Ageing
11 Hindmarsh Square
Adelaide, South Australia 5000

in collaboration with:

Australian Commission on Safety and Quality in Health Care
Level 5, 255 Elizabeth Street
Sydney, New South Wales 2000

Enquiries for SA Department for Health and Ageing to Vicki McNeil:
[email protected]
Ph: +61 8 7425 7169

Enquiries for ACSQHC to Professor John Turnidge:
[email protected]
Ph: +61 2 9126 3508

This annual report can be accessed at the websites of the South Australian Department for Health and Ageing (www.sahealth.sa.gov.
au/nausp), and the Australian Commission on Safety and Quality in Health Care (www.safetyandquality.gov.au).

Disclaimer: The data presented in this report were correct at the time of publication and reflect usage rates based on data on
antimicrobial quantities and occupied bed-days supplied by individual contributors. Minor discrepancies with previous reports may
occur as a result of data adjustments made by contributing hospitals.

This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an
acknowledgment of the source. Requests and inquiries concerning reproduction and rights for purposes other than those indicated
above require the written permission of the Australian Commission on Safety and Quality in Health Care, GPO Box 5480, Sydney, NSW
2001, or [email protected]

This publication is part of the work being conducted by the Australian Commission on Safety and Quality in Health Care to establish
a national antimicrobial resistance and usage surveillance system. The work is being undertaken through the Antimicrobial Use and
Resistance in Australia (AURA) project.

The Australian Commission on Safety and Quality in Health Care wishes to thank those involved in producing this report.

mailto:vicki.mcneil%40sa.gov.au?subject=
http://www.sahealth.sa.gov.au/nausp
http://www.sahealth.sa.gov.au/nausp

Page 27

2014 National Antimicrobial Utilisation Surveillance Program 23

Table 4 Total-hospital antibacterial usage rates (DDDs per 1000 OBDs) by antibacterial
group, 2010–14

Antibiotic class
2010

(n = 53)
2011

(n = 61)
2012

(n = 79)
2013

(n = 114)
2014

(n = 129)

Aminoglycosides 50.87 46.50 44.49 41.52 38.45

Amphenicols 0.01 0.00 0.00 0.00 0.00

β-lactamase inhibitor combinations 185.15 186.99 187.57 186.82 180.70

β-lactamase-resistant penicillins 87.35 84.27 85.30 91.29 91.03

β-lactamase-sensitive penicillins 27.78 23.68 25.58 26.74 28.66

Carbapenems 19.02 18.27 18.88 19.49 17.79

Extended-spectrum penicillins 117.04 112.10 107.52 104.83 103.39

First-generation cephalosporins 139.04 142.48 132.39 133.66 130.90

Fluoroquinolones 53.37 51.06 43.53 42.90 39.21

Fourth-generation cephalosporins 6.03 5.49 5.21 5.24 5.50

Glycopeptides 31.34 32.05 29.65 28.95 26.01

Lincosamides 12.96 13.93 14.06 15.59 14.93

Macrolides 86.17 85.38 80.49 71.81 67.13

Monobactams 0.20 0.18 0.36 0.42 0.45

Nitrofurans 1.23 1.11 0.87 0.88 0.81

Nitroimidazoles 51.65 52.77 47.71 44.76 40.80

Other antibacterials (daptomycin + linezolid) 1.56 1.16 2.18 2.40 2.38

Other cephalosporins and penems (ceftaroline) 0.00 0.00 0.00 0.04 0.05

Polymyxins 0.43 0.58 0.63 0.81 0.77

Rifamycins 7.74 7.84 6.38 5.99 5.06

Second-generation cephalosporins 5.39 5.83 5.41 5.55 5.75

Steroids 2.42 2.33 1.93 1.61 1.34

Streptogramins 0.13 0.42 0.54 0.51 0.51

Streptomycins 0.03 0.05 0.01 0.01 0.00

Sulfonamide/trimethoprim combinations 13.90 13.56 14.95 16.62 16.18

Tetracyclines 31.28 37.35 43.08 47.96 54.34

Third-generation cephalosporins 50.17 51.47 49.50 48.99 46.17

Trimethoprim 23.44 21.53 20.57 19.75 18.00

Total 1005.70 998.38 968.79 965.14 936.31

Note: Figures may vary slightly from previous reports as a result of retrospective data adjustments.

Page 28

Antimicrobial use in Australian hospitals24

Antimicrobial usage rates by
individual agent, 2014
This section shows usage rates of individual
antimicrobial agents, demonstrating trends over
the past five years.

Aminoglycosides – amikacin,
gentamicin, tobramycin

Gentamicin is the most commonly used
aminoglycoside in Australia. Usage rates have

steadily decreased over the past five years in
all Australian states (Figure 14). Amikacin and
tobramycin usage rates remain low compared with
gentamicin rates. Higher usage rates of tobramycin
appear to be confined to larger hospitals with
referral services for cystic fibrosis patients.

Figure 14 Aminoglycoside usage rates, 2010–14 (3-month moving average)

Note: Tobramycin usage rates include inhaled formulations.

Page 53

2014 National Antimicrobial Utilisation Surveillance Program 49

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Page 54

For more information

Infection Control Service
Public Health and Clinical Systems

SA Department for Health and Ageing
11 Hindmarsh Square
Adelaide, South Australia 5000

Telephone: 1300 232 272

www.sahealth.sa.gov.au/

AURA Project
Australian Commission on Safety
and Quality in Health Care

Level 5, 255 Elizabeth Street
Sydney, New South Wales 2000

Telephone: 02 9126 3600

www.safetyandquality.gov.au/



Public-I3-A1

http://www.sahealth.sa.gov.au

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