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Impact of generic entry on hospital antimicrobial use: a retrospective quasi-experimental interrupted time series analysis

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dc.contributor.author Espona, Mercè
dc.contributor.author Echeverría Esnal, Daniel
dc.contributor.author Hernández, Sergi
dc.contributor.author Almendral, Alexander
dc.contributor.author Gómez-Zorrilla, Silvia
dc.contributor.author Limón, Enric
dc.contributor.author Ferrández, Olivia
dc.contributor.author Grau Cerrato, Santiago
dc.date.accessioned 2022-05-13T06:06:14Z
dc.date.available 2022-05-13T06:06:14Z
dc.date.issued 2021
dc.identifier.citation Espona M, Echeverria-Esnal D, Hernandez S, Almendral A, Gómez-Zorrilla S, Limon E, et al. Impact of generic entry on hospital antimicrobial use: a retrospective quasi-experimental interrupted time series analysis. Antibiotics (Basel). 2021 Sep 24; 10(10): 1149. DOI: 10.3390/antibiotics10101149
dc.identifier.issn 2079-6382
dc.identifier.uri http://hdl.handle.net/10230/53071
dc.description.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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher MDPI
dc.rights Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Impact of generic entry on hospital antimicrobial use: a retrospective quasi-experimental interrupted time series analysis
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3390/antibiotics10101149
dc.subject.keyword Antibiotic policy
dc.subject.keyword Antibiotics
dc.subject.keyword Antimicrobial consumption
dc.subject.keyword Branded antibiotics
dc.subject.keyword Defined daily doses
dc.subject.keyword Veneric antibiotics
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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