Monthly Webinar Tuesday 12th December 2017, 16:00 Brewing Up a Little Storm Event number: 849 291 546 Audio dial-in (phone): 01 526 0058
AMS InSight Monthly Webinar: Tuesday 12th December MicroB: Brewing Up a Little Storm Ajay Oza HSE-Health Protection Surveillance Centre @hpscireland @AMSInSight 2
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How? European Surveillance of Antimicrobial Surveillance (ESAC-NET) o WHO has a code Anatomic Therapeutic Chemical (ATC) and value Defined Daily Dose (DDD) for each drug How many packs what drug strength particular location specific time period o Map this to ATC/DDD, sum and express as a rate Germentin 500mg/125mg x 16 Fc Tabs J01CR02 8.0 DDD 5
Lessons from the primary care ECDC map reflects the state of submissions in TESSy as of 2017-12-08 at 14:30; 2016 Data Source: HPSC and IMS dara; BL shows FQ and Pens 6
EU ESAC-Net Hospital Use Data (2016) Ireland has mid rage usage J01 (excludes a new antibiotics) Not all countries have data Rate expressed as DDD per 1000 Inhabitants per day (NOT per bed-days used) EU Rank: 12/23 Report has been generated from ESAC-Net data submitted to TESSy, The European Surveillance System on 2017-12-08. The report reflects the state of submissions in TESSy as of 2017-12-08 at 14:30 7
Stages of Surveillance Implementation Stage for Hospital Antimicrobial Consumption Surveillance Stage Ireland EU ESAC-Net Total Use Data Only (Hospital + Primary) NA NA Total hospital usage as aggregate data NA Almost Fully Disaggregate usage by individual hospitals Fully Pilot Risk-adjusted usage by individual hospitals Study WHO-Europe AMC programme Fully 8
Two Neighbouring General Hospitals 9
Range in Hospitals 10
Distribution by Drug Class 11
Amoxicillin and Enzyme Inhibitor J01CR02 Examples: Co-amoxiclav EU Rank: 10/23 12
Piperacillin and Enzyme Inhibitor J01CR05 Examples: Pip-tazo EU Rank: 1/23 13
Beta-lactamase Resistant Penicillins J01CF Examples: Flucloxacillin Oxacillin Meticillin EU Rank: 4/23 14
Beta-lactamase Sensitive Penicillins J01CE Examples: Benzylpenicillin EU Rank: 10/23 15
Macrolides J01FA Examples: Erythromycin Clarithromycin EU Rank: 3/23 16
Fluoroquinolones J01MA Examples: Ciprofloxacin EU Rank: 21/23 17
Glycopeptides J01XA Examples: IV Vancomycin IV Metronidazole EU Rank: 4/23 18
Vancomycin J01XA01 Examples: IV Vanc EU Rank: 1/23 19
Third-Generation Cephalosporins J01DD Examples: Cefotaxime Cetriaxone EU Rank: 22/23 20
Gentamicin J01GB03 Examples: Gent EU Rank: 7/23 21
Colistin J01XB01 Examples: EU Rank: 12/23 22
Carbapenems J01DH Examples: Meropenem EU Rank: 7/23 23
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Acute Hospitals CVS files prepared by pharmacists for each period Automated custom results (feedback 1) Denominator data All Files Uploaded to MicroB 1. Directly by hospitals OR2. Sent to HPSC via email, then uploaded Approval Automated final reports (feedback 2) MicroB: Antimicrobial Consumption Flowchart Rates calculated for each hospital and final results prepared Final results reviewed by stewardship group Results for each period (biannually) published via Public MicroB platform on HPSC website 26
Demonstration o Home page secure site o Status & flowchart o CSV example o Upload page o Raw file details page (cost check) o Feedback one (raw DDD) o Custom / Top-tens Pages o Feedback two (rates) o Excel report o OPEN report HPSC website o Future Directions 27
Acknowledgements o Antimicrobial pharmacists in Ireland o Infection control teams and microbiology laboratories in hospitals o Colleagues at HPSC & HSE o ESAC-Net at ECDC 28
Next Webinar: Tuesday 9th January @16:00 New Year Resolutions