Antimicrobial use varies across hospital units

Patients in surgical critical care units were most likely to receive antimicrobial medication, while those in nursery wards were least likely to receive it, according to a recent study.

Nearly 78% of patients who used a surgical critical care unit (CCU) received antimicrobials in 2011, with 71% of patients in medical-surgical pediatric CCUs receiving antimicrobials and patients in cardiothoracic CCUs receiving antimicrobials at a 68% rate, according to Dr. Shelley S. Magill of the Centers for Disease Control and Prevention, Atlanta, and her associates (JAMA 2014;312:1438-46).

With only 3% of patients receiving antimicrobials, nursery wards had the lowest rate of medication, with labor, delivery, recovery, and postpartum wards giving antimicrobials to 20% of patients and 22% of patients receiving antimicrobials in special care nurseries, they reported.

Of the 5,635 patients who received antimicrobials, 4,278 received them for the treatment of infection. Lower respiratory tract infections were the most commonly treated type of infection, with 35% of patients receiving antimicrobials. Urinary tract and skin and soft tissue infections also were commonly treated with antimicrobials at a rate of 22% and 16%, respectively.

Overall (including prophylaxis,noninfection-related reasons, and undocumented rationale), vancomycin was the most commonly received antimicrobial, followed by cefazolin and ceftriaxone, according to Dr. Magill and her associates.

The study used data collected during 1-day prevalence surveys at 183 U.S. acute care hospitals and involving 11,282 patients.

[DW] Prevalence of antimicrobial use by hospital location

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