Pilot study of an online hospital antibiotic use tracking and reporting system

Background: Antimicrobial use (AMU) varies widely among hospitals, suggesting a need to better monitor usage and evaluate the effectiveness of antimicrobial stewardship programs (ASPs). Our objective was to assess the feasibility of implementing an online voluntary hospital antibiotic use tracking and reporting system. Methods: An online survey was sent to ASP clinicians representing hospitals across Ontario. Hospitals that tracked total hospital-wide inpatient antibiotic use in 2017 were asked to submit either days of therapy (DOT) or defined daily doses (DDD), along with separate inpatient days (PD), which were used as the denominator. Respondents who indicated no hospital-wide AMU tracking were asked to describe the barriers to its use. Antibiotic use was displayed on a public website for consenting hospitals. Results: Of 201 eligible hospitals, 66 (33%) provided AMU data representing 10,634 of 25,208 (43%) eligible inpatient beds in the province. DOT and DDD data were provided by 36 hospitals, each. Weighted average antibiotic use was highest in acute teaching hospitals (513 DOT/1,000 PD, 709 DDD/1,000 PD) and lowest in complex continuing care and rehabilitation facilities (158 DOT/1,000 PD, 159 DDD/1,000 PD). Barriers cited for providing hospital-wide AMU data include lack of time and resources to collect and evaluate AMU data and technological limitations preventing data collection. Conclusion: Integrating hospital AMU tracking and reporting as part of a voluntary initiative is feasible, with relatively broad participation. Short of a legislative mandate for participation, opportunities still exist to increase representation, including provision of guidance and technical support to help hospitals track and share AMU.