Antibiotic use in Dutch hospitals 1991-1996

The use of antibiotics in Dutch hospitals between 1991 and 1996 was investi gated. A total of 54 hospitals responded to the enquiry, representing over 70% of all hospital beds in The Netherlands. The use of antibiotics in Dutc h hospitals, expressed as defined daily doses (DDD) per hundred bed days, g radually increased from 37.2 DDD per 100 bed days in 1991 to 42.5 DDD per 1 00 bed days in 1996. The antibiotic that showed the largest increase in use was co-amoxiclav. Its use increased more than three-fold from 3.93 DDD per 100 bed days in 1991 to 12.5 DDD per 100 bed days in 1996. The increase in use of co-amoxiclav exceeded the increase in total antibiotic consumption. The use of cephalosporins remained fairly constant during the study period , but there were changes in the relative use of the different cephalosporin groups. The use of earlier cephalosporins gradually decreased, whereas the use of the more recently developed cephalosporins increased between 1991 a nd 1996. Ciprofloxacin and norfloxacin were the most commonly used fluoroqu inolones throughout the study period. The use of ofloxacin increased signif icantly between 1991 and 1996, approaching the levels of use of ciprofloxac in and norfloxacin. There may be complex reasons for the increases, which n eed further analysis, but they mirror those few data available from elsewhe re in the world. Possible explanations include more intensive treatment to expedite patient discharges, sicker patients with more serious infections a nd more resistant organisms.