The European Surveillance of Antimicrobial Consumption (ESAC) Point-Prevalence Survey of Antibacterial Use in 20 European Hospitals in 2006

Background. Point-prevalence surveys have been used to document antimicrobial use in hospitals for 120 years. However, published surveys are inconsistent with respect to population, indication, and the details of therapy that were included. We aimed to standardize a method for surveillance of antibacterial use in hospitals from different health care systems and to identify targets for quality improvement. Methods. We adapted a Web-based reporting system from STRAMA, the Swedish Strategic Programme against antibiotic resistance. One hospital from each of 20 countries took part in the survey, which was completed during 2 calendar weeks during 1 April 2006 through 31 May 2006. The survey included all inpatient beds for adults and children and identified all patients who were receiving systemic antibacterial treatments on the day of survey and all patients who had received antibacterial prophylaxis for surgery on the previous day. Results. On the day of survey there were 11,571 inpatients in the 20 participating hospitals, of whom 30.1% were receiving antibacterial treatment (range, 19%-59%). The most common anatomic sites of infection for which antibacterials were prescribed were respiratory tract (24%); skin, bone, and joint (18%);intra-abdominal organs (16%); and urinary tract (11%). The following 3 quality indicators were identified: indication documented in case notes (64%), prophylaxis for surgery not continued for 124 h (60%), and therapy for community-acquired pneumonia not including third-generation cephalosporins or quinolones (78.5%). Conclusion. A Web-based method for a point-prevalence survey was successfully piloted in 20 hospitals across Europe and offers a standardized instrument that can identify targets for quality improvement.