Facts and statistics about the use of antibiotics in the inpatient sector in Switzerland.
The total consumption of antibiotics (ATC group J01) for systemic use in the swiss inpatient sector was 52.7 DDD per 100 days of care or 1.3 DDD per 1000 inhabitants per day in 2018. In comparison, total consumption in Europe (ESAC-Net) was 2.0 DDD per 1000 inhabitants per day (range: 0.9 – 3.1) in 2017 . Antibiotic consumption in the inpatient sector in Switzerland has decreased slightly since 2014. In 2018, there were only minor regional differences in the consumption of antibiotics in inpatient medicine throughout Switzerland. A slightly lower consumption in the Italian-speaking part might be explained with the fact that this part has no university centre.
A classification of hospitals into small hospitals (up to 200 beds), medium-sized hospitals (200-500 beds) and large hospitals (over 500 beds) shows that there were major differences in antibiotic consumption within hospital classes in 2018. Large hospitals, with more complex cases on average show a higher antibiotic consumption than small and medium-sized hospitals.
The Swiss antibiotic consumption according to the AWaRe classification
WHO has developed a classification system for antibiotics which divides existing antibiotics into three categories: Access, Watch and Reserve (“AWaRe”, 1). Antibiotics from the “Access” category should be preferred in general due to their effectiveness and their moderate contribution to the development of resistances compared with other antibiotics. The “Watch” category includes antibiotics which are only indicated for a limited number of infections, while “Reserve” antibiotics are only used as a last resort.
The consumption of “Access” antibiotics has remained largely unchanged in Swiss hospitals in recent years, while the consumption of antibiotics of the “Watch” group tended to decrease slightly. The consumption of “Reserve” antibiotics doubled since 2010 although on a very low level (0.63 DDD per 100 days of care in 2018).
The most frequently used antibiotics in Swiss hospitals in 2018 were penicillins in combination with a beta-lactamase inhibitor (33%; ATC=J01CR), above all amoxicillin clavulanic acid (28%), but also cephalosporins (23%; J01D), such as cefuroxime a 2nd generation cephalosporin (8%) or ceftriaxone a 3rd generation cephalosporin (10%) were widely used. Further Fluoroquinolones (8%, J01MA) and macrolides (7%, J01F) were frequently used in inpatient medicine.