{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:01:58Z","timestamp":1753876918903,"version":"3.41.2"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T00:00:00Z","timestamp":1602806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In 2019 the WHO fully adopted new DDD values. The objective of this study is to analyse their impact on the measurement of consumption of antibacterials in hospitals participating in the Catalan Infection Control and Antimicrobial Stewardship National Program (VINCat-PROA) in Catalonia (Spain) between 2008 and 2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The anatomical therapeutic chemical\/DDD system was used to monitor adult hospital antibacterial consumption expressed in DDD\/100\u2005bed-days. Consumption from 2008 to 2018 was calculated using both pre- and post-update DDD values. Differences were calculated as the percentage variation in DDD\/100\u2005bed-days and analysed with Student\u2019s t-test. Simple linear regressions were performed to evaluate the trends in adult antimicrobial consumption over the study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall consumption according to post-update DDD values decreased by 12.2% (P\u2009&amp;lt;\u20090.001) compared with the pre-update DDD values. Penicillins (\u221219.6.%; P\u2009&amp;lt;\u20090.001) and carbapenems (\u221219.0%; P\u2009=\u20090.023) showed the greatest reduction, followed by cephalosporins (\u22127.7%; P\u2009=\u20090.021) and quinolone antibacterials (\u22127.7%; P\u2009=\u20090.017). ICU services showed the greatest overall reduction (\u221213.1%; P\u2009&amp;lt;\u20090.001). From 2008 to 2018 there was a statistically significant decrease in consumption of penicillins and quinolone antibacterials and a statistically significant increase in cephalosporin and carbapenem consumption with both pre- and post-update DDD values. There were no variations in the ranking of consumption between the pre- and post-update DDD values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The WHO\u2019s updates of DDDs have had a significant impact on the measurement of antibacterial consumption. In our region, they have corrected an overestimation of penicillin and carbapenem consumption amounting to 19%. It is essential to bear these findings in mind for an accurate assessment of temporal trends and benchmarking.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaa079","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T11:19:10Z","timestamp":1599218350000},"source":"Crossref","is-referenced-by-count":3,"title":["Impact of changes in the WHO\u2019s 2019 update of DDDs on the measurement of adult hospital antibacterial consumption in Catalonia (Spain), 2008\u201318"],"prefix":"10.1093","volume":"2","author":[{"given":"Santiago","family":"Grau","sequence":"first","affiliation":[{"name":"Service of Pharmacy, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group, Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0461-6190","authenticated-orcid":false,"given":"Sergi","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"VINCat Program Surveillance of healthcare related infections in Catalonia, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enric","family":"Lim\u00f3n","sequence":"additional","affiliation":[{"name":"VINCat Program Surveillance of healthcare related infections in Catalonia, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Calbo","sequence":"additional","affiliation":[{"name":"VINCat Program Surveillance of healthcare related infections in Catalonia, Barcelona, Spain"},{"name":"Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitari M\u00fatua Terrassa, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan P","family":"Horcajada","sequence":"additional","affiliation":[{"name":"Service of Infectious Diseases, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group, Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona, Universitat Pompeu Fabra, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Catalan Infection Control and Antimicrobial Stewardship National Program (VINCat-PROA)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Cano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Canadell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Juli\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Gratac\u00f3s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nat\u00e0lia","family":"Carrasco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariadna","family":"Padulles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carles","family":"Qui\u00f1ones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Campany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ant\u00f2nia","family":"Balet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montse","family":"Llad\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gl\u00f2ria","family":"Gayola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Frigola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludivina","family":"Ib\u00e1\u00f1ez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonor","family":"Munell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Gol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maite","family":"Barrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma Rosa","family":"Garriga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Us\u00fae","family":"Manso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00faria","family":"Miserachs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esperanza","family":"Gil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00faria","family":"Bosacoma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anisi","family":"Mor\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Capell\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Curiel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireia","family":"Fuster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camil\u00b7","family":"la Valls","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa","family":"Gra\u00f1\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Sagal\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bego\u00f1a","family":"Pascual","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Sard\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eug\u00e8nia","family":"\u00d2dena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Terr\u00e8","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Alemany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Salvador","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Mart\u00ed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma Jos\u00e9","family":"Fraile","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"de Puig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Navarro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edurne","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Sals\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Montero","family":"Leno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia Maria","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Torrent","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magda","family":"Montserrat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Enrique-Taranc\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Carrascosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Dom\u00ednguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Serrais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daria","family":"Ayago","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Arranz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Clop\u00e8s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00faria","family":"Ort\u00ed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Guerrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Barbadillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Brandariz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Ayestaran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar","family":"Pascual","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduard","family":"Hidalgo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flotats","family":"Vidal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Serrano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,16]]},"reference":[{"author":"WHO. Surveillance of Antimicrobial Use","key":"2021052708202012700_dlaa079-B1"},{"author":"ECDC. European Surveillance of Antimicrobial Consumption Network (ESAC-Net","key":"2021052708202012700_dlaa079-B2"},{"key":"2021052708202012700_dlaa079-B3","doi-asserted-by":"crossref","first-page":"9788","DOI":"10.1038\/s41598-019-46078-y","article-title":"Antibiotic drug-resistance as a complex system driven by socio-economic growth and antibiotic misuse","volume":"9","author":"Malik","year":"2019","journal-title":"Sci Rep"},{"author":"WHO","key":"2021052708202012700_dlaa079-B4"},{"author":"WHO Collaborating Centre for Drug Statistics Methodology, Norwegian Institute of Public Health. DDD Alterations from 2005-2020","key":"2021052708202012700_dlaa079-B5"},{"author":"WHO Collaborating Centre for Drug Statistics Methodology, Norwegian Institute of Public Health","key":"2021052708202012700_dlaa079-B6"},{"key":"2021052708202012700_dlaa079-B7","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.3389\/fphar.2018.01156","article-title":"Antimicrobial medicines consumption in Eastern Europe and Central Asia\u2014an updated cross-national study and assessment of quantitative metrics for policy action","volume":"9","author":"Robertson","year":"2019","journal-title":"Front Pharmacol"},{"key":"2021052708202012700_dlaa079-B8","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1093\/jac\/dkt268","article-title":"WHO defined daily doses versus hospital-adjusted defined daily doses: impact on results of antibiotic use surveillance","volume":"68","author":"Haug","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"2021052708202012700_dlaa079-B9","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.medmal.2018.10.009","article-title":"Impact of amoxicillin and oral amoxicillin-clavulanic acid defined daily doses on consumption indicators","volume":"49","author":"Charra","year":"2019","journal-title":"Med Mal Infect"},{"key":"2021052708202012700_dlaa079-B10","doi-asserted-by":"crossref","first-page":"E3463","DOI":"10.1073\/pnas.1717295115","article-title":"Global increase and geographic convergence in antibiotic consumption between 2000 and 2015","volume":"115","author":"Klein","year":"2018","journal-title":"Proc Natl Acad Sci USA"},{"key":"2021052708202012700_dlaa079-B11","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2019.24.34.1900022","article-title":"Antimicrobial use trends, Israel, 2012 to 2017","volume":"24","author":"Dickstein","year":"2019","journal-title":"Euro Surveill"},{"key":"2021052708202012700_dlaa079-B12","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1093\/jac\/dks190","article-title":"Intensification of antibiotic use within acute care hospitals in the Netherlands","volume":"67","author":"Kwint","year":"2012","journal-title":"J Antimicrob Chemother"},{"key":"2021052708202012700_dlaa079-B13","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0213-005X(12)70096-4","article-title":"Antibiotic consumption at 46 VINCat hospitals from 2007 to 2009, stratified by hospital size and clinical services","volume":"30 Suppl 3","author":"Grau","year":"2012","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"2021052708202012700_dlaa079-B14","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1001\/jamainternmed.2015.5389","article-title":"Risk of aortic dissection and aortic aneurysm in patients taking oral fluoroquinolone","volume":"175","author":"Lee","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2021052708202012700_dlaa079-B15","doi-asserted-by":"crossref","first-page":"87","DOI":"10.2165\/00002018-199615020-00001","article-title":"Neurotoxicity of carbapenem antibacterials","volume":"15","author":"Norrby","year":"1996","journal-title":"Drug Saf"},{"key":"2021052708202012700_dlaa079-B16","doi-asserted-by":"crossref","first-page":"1900656","DOI":"10.2807\/1560-7917.ES.2019.24.46.1900656","article-title":"Decreasing and stabilising trends of antimicrobial consumption and resistance in Escherichia coli and Klebsiella pneumoniae in segmented regression analysis, European Union\/European Economic Area, 2001 to 2018","volume":"24","author":"Pe\u00f1alva","year":"2019","journal-title":"Euro Surveill"}],"container-title":["JAC-Antimicrobial Resistance"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jacamr\/article-pdf\/2\/4\/dlaa079\/38275200\/dlaa079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jacamr\/article-pdf\/2\/4\/dlaa079\/38275200\/dlaa079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T08:23:42Z","timestamp":1622103822000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jacamr\/article\/doi\/10.1093\/jacamr\/dlaa079\/5925473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,16]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,10,16]]}},"URL":"https:\/\/doi.org\/10.1093\/jacamr\/dlaa079","relation":{},"ISSN":["2632-1823"],"issn-type":[{"type":"electronic","value":"2632-1823"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,10,16]]},"article-number":"dlaa079"}}