Effect of Facility Characteristics and Medical Staff Associated with Adoption of Carbapenem in Hospitals: Questionnaire Survey in Niigata

Abstract

To determine the factors associated with adoption of carbapenem, we conducted a questionnaire survey in Niigata. Responses were obtained from 81 out of 125 facilities. We divided two groups based on 63 acute care and 18 long-term care hospitals, and evaluated the factors associated with adoption of carbapenem. As a result, a median number of carbapenem adoptions in acute care and long-term care hospitals were significantly different between 3 and 2 (P<0.01), respectively. The adoption rates of carbapenem in acute care and long-term care hospitals were not significantly different between 94% and 89% in meropenem, and 79% and 59% in imipenem/cilastatin, respectively. However, the adoption rates of carbapenem in acute care and long-term care hospitals were significantly different between 56% and 17% in doripenem (P<0.01), 48% and 6% in biapenem (P<0.01), and 44% and 11% in panipenem/betamipron (P<0.01), respectively. Additionally, multiple linear regression analyses demonstrated that acute-care hospitals (P=0.02) and registered infection control doctors (P=0.03) had a significant positive association with the number of carbapenem adoptions. In conclusion, we clarified that there are different factors for carbapenem adoption, depending on the characteristics of the hospital. The isolation rates of antimicrobial resistance were reported to be different between acute care and long-term care. Therefore, further investigation is needed to understand the relationship between antimicrobial resistance and carbapenem adoption. We also consider that a certified pharmacist is needed for activities related to antibiotic adoption.