Impact of Generic Entry on Hospital Antimicrobial Use : A Retrospective Quasi-Experimental Interrupted Time Series Analysis
Espona, Mercè (Institut Hospital del Mar d'Investigacions Mèdiques)
Echeverría-Esnal, Daniel (Institut Hospital del Mar d'Investigacions Mèdiques)
Hernandez, Sergi (VINCat Program Surveillance of Healthcare Related Infections in Catalonia, 08097 Barcelona, Spain; (S.H.); (A.A.); (E.L.))
Almendral, Alexander (Institut Català de la Salut)
Gómez-Zorrilla, Silvia (Hospital del Mar (Barcelona, Catalunya))
Limón, Enric (Institut Català de la Salut)
Ferrández, Olivia (Hospital del Mar (Barcelona, Catalunya))
Grau, Santiago (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)

Date:	2021
Abstract:	Background: The impact of antimicrobials generic entry (GE) is controversial. Their introduction could provide an economic benefit yet may also increase their consumption, leading to a higher risk of resistance. Our aim was to analyze the impact of GE on trends of antimicrobial consumption in an acute-care hospital. Methods: A retrospective quasi-experimental interrupted time series analysis was conducted at a 400-bed tertiary hospital in Barcelona, Spain. All antimicrobials for systemic use for which a generic product entered the hospital from January 2000 to December 2019 were included. Antimicrobial consumption was expressed as DDD/100 bed days. Results: After GE, the consumption of cefotaxime (0. 09, p < 0. 001), meropenem (0. 54, p < 0. 001), and piperacillin-tazobactam (0. 13, p < 0. 001) increased, whereas the use of clindamycin (-0. 03, p < 0. 001) and itraconazole (-0. 02, p = 0. 01) was reduced. An alarming rise in cefepime (0. 004), daptomycin (1. 02), and cloxacillin (0. 05) prescriptions was observed, despite not achieving statistical significance. On the contrary, the use of amoxicillin (-0. 07), ampicillin (-0. 02), cefixime (-0. 06), fluconazole (-0. 13), imipenem-cilastatin (-0. 50) and levofloxacin (-0. 35) decreased. These effects were noticed beyond the first year post GE. Conclusions: GE led to an increase in the consumption of broad-spectrum molecules. The potential economic benefit of generic antibiotics could be diluted by an increase in resistance. Antimicrobial stewardship should continue to monitor these molecules despite GE.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Antibiotic policy ; Generic antibiotics ; Branded antibiotics ; Antibiotics ; Defined daily doses ; Antimicrobial consumption
Published in:	Antibiotics, Vol. 10 (september 2021) , ISSN 2079-6382

DOI: 10.3390/antibiotics10101149
PMID: 34680730

11 p, 1.3 MB

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