Hospital usage of antibacterial agents in relation to size and type of hospital and geographical situation

Purpose The objective of this study was to evaluate the level of use and therapy profile of antibacterial agents in hospitals. Further to explore whether type, size or geographical situation influenced antibacterial agents used. Methods Antibacterial use during 1998-1999, in 13 hospitals, including emergency, referral and university hospitals from all health regions in Norway, were collected retrospectively. Drugs were classified according to the ATC classification and the ATC/DDD index 2001 and standardised bed-days were used. Results Total annual use varied significantly between hospitals (p < 0.01), mean 47.5 DDD/100 bed-days. Neither size, type of hospital, nor were geographical situations predictors for total hospital use of antibacterial agents. Therapy patterns were approximately similar all over the country. Beta-lactamase sensitive penicillins were most frequently used in all hospitals. University hospitals and large hospitals used more 3rd generation cephalosporins. Small hospitals used more penicillins with extended specter. Conclusions Size, type and geographical situation do not influence the level of antibacterial use in Norwegian hospitals. However, therapeutic choice of antibacterial agents differs and seems to be influenced by hospital size and hospital type. Copyright (c) 2005 John Wiley & Sons, Ltd.