Antibiotic use rising at VA facilities

Antibiotic use is rising at Veterans Affairs medical facilities across the country. The new finding, based on bar-code medication administration data, showed that antibiotic use rose steadily between 2005 and the end of 2009. The findings were released at the annual meeting of the Society for Healthcare Epidemiology of America in Dallas.

“The sharpest rise in use was in broad-spectrum antibiotics,” said lead author Makoto Jones, MD, University of Utah IDEAS Center, Salt Lake City. “More than half of patients received at least 1 dose of antibiotics during a VA hospital stay during those 5 years, and fluoroquinolones were the largest single class used, at about 20%. Our findings agree with regional and local studies relative to antibiotic use around the country.”

Researchers analyzed data on antibiotic use for 110 of 124 VA acute care sites across the country. The other 14 sites had an average of fewer than 100 occupied patient days on acute care wards per month over the study period or did not have bar-code medication administration data for the entire study period.

Antibiotic use showed a gradual increase from 649 days of therapy per 1,000 patient days in early 2005 to 775 days of therapy per 1,000 patient days 5 years later. The largest increases were seen in carbapenems (up 102%), intravenous vancomycin (up 79%), and penicillin beta-lactamase inhibitors (up 41%).

“The use of these broad-spectrum antibiotics affects not just patients, but everyone who works in the hospital,” Dr. Jones said. “Clinicians want to hit infections hard and hit fast, which is the general recommendation for antibiotics, but we believe that antibiotic stewardship can help guide more appropriate use.”