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SDG 3: Antimicrobial resistance

Abstract

BACKGROUND

To enhance antibiotic stewardship and effectively address antimicrobial resistance (AMR), better understanding of subnational antibiotic consumption patterns is essential.

AIM

We aimed to assess antibiotic consumption in Germany using data from 2022 and integrated from two surveillance systems, focusing on regional differences by examining non-university acute care hospitals.

METHODS

We used pharmacy dispensing data from 525 regional or local hospitals and 35 university hospitals, covering 46.5 million patient days (PD), nearly half of all occupied bed days nationwide, to calculate antibiotic use densities (AUD) for systemic antibiotics, expressed as World Health Organization (WHO) ATC/DDD (Anatomical Therapeutic Chemical/Defined Daily Dose) per 100 patient days (DDD/100 PD). The analysis primarily focused on consumption patterns in non-university hospitals, assessing key antibiotic groups through mixed-effects regression. For sensitivity analyses, we employed hospital-adapted daily dose definitions.

RESULTS

Pooled AUD for participating non-university hospitals was 51.8 DDD/100 PD, with aminopenicillins/beta-lactamase inhibitors being the most prescribed group. Regression analyses, adjusted for hospital size and ward type/admitting specialty, indicated notable regional variation. We identified statistically significant differences in antibiotic consumption, particularly for beta-lactam antibiotics, fluoroquinolones and tetracyclines. For example, several regions exhibited up to 1.4-fold higher use of first- and second-generation cephalosporins compared with the western reference region.

CONCLUSION

This study highlights substantial regional variation in antibiotic use in German acute care hospitals, underlining the importance of further investigation into influencing factors such as regional guidelines and resistance rates. The methodological approach applied here may serve as a model for other countries interested in analysing regional differences in antibiotic consumption.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-11-13
2026-04-18
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Antibiotic consumption patterns in acute care hospitals: an integrated analysis using regression modelling combining data from two surveillance systems, Germany, 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Karin+Gr%C3%B6schner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gröschner Karin</a>, <a href="/search?value1=Winfried+V+Kern&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kern Winfried V</a>, <a href="/search?value1=Tim+Eckmanns&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eckmanns Tim</a>, <a href="/search?value1=Birgitta+Schweickert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schweickert Birgitta</a>, <a href="/search?value1=Gesche+F%C3%B6rst&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Först Gesche</a>, <a href="/search?value1=Ulrike+Georgi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Georgi Ulrike</a>, <a href="/search?value1=Marcel+Feig&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Feig Marcel</a>, <a href="/search?value1=Michaela+Steib-Bauert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Steib-Bauert Michaela</a>, <a href="/search?value1=Niklas+Willrich&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Willrich Niklas</a>, <a href="/search?value1=Katja+de+With&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de With Katja</a></span>. Antibiotic consumption patterns in acute care hospitals: an integrated analysis using regression modelling combining data from two surveillance systems, Germany, 2022. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(45):pii=2500560. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.45.2500560" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.45.2500560</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 23 Jul 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 04 Oct 2025 </span> </p>
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