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Table 2 Joinpoint regression analysis of antibiotic utilisation rate (defined daily doses per 1,000 inpatient-days) across five public acute-care hospitals for selected antibiotics, H1 of 2011 to H2 of 2020

From: Antibiotic utilisation and resistance over the first decade of nationally funded antimicrobial stewardship programmes in Singapore acute-care hospitals

Antibiotic

DDDs/1,000 inpatient-days

Total study period

(H1 2011–H2 2020)

Trend 1

Trend 2

Trend 3

 

Trend 4

 

H1 2011

H2

2020

AHPC (%), (95% CI)

Half-years

HPC (%)

(95% CI)

Half-years

HPC (%)

(95% CI)

Half-years

HPC (%),

(95% CI)

Half-years

HPC (%),

(95% CI)

All

715.6

509.5

-1.8***

(-2.3, -1.3)

H1 2011–H2 2018

-4.0***

(-5.2, -2.8)

H2 2018–H2 2020

-0.5*

(-1.1, -0.01)

    

Anti-pseudomonal antibiotics1

530.6

352.1

-2.2***

(-2.7, -1.7)

H1 2011–H2 2014

-4.5***

(-5.8, -3.3)

H2 2014–H2 2020

-0.8**

(-1.4, -0.3)

    

Third generation cephalosporins2

101.1

61.4

-2.9***

(-3.5, -2.2)

H1 2011–H1 2014

-5.6***

(-7.4, -3.8)

H1 2014–H2 2020

-1.6***

(-2.1, -1.0)

    

Ceftazidime, IV (g)

8.3

8.3

-0.6*

(-1.0, -0.1)

        

Ceftriaxone, IV (g)

92.9

53.1

-3.1***

(-3.8, -2.5)

H1 2011–H1 2014

-6.0***

(-7.8, -4.3)

H1 2014–H2 2020

-1.8***

(-2.3, -1.2)

    

Carbapenems3

51.1

38.0

-1.8***

(-2.7, -0.8)

H1 2011–H2 2017

-0.4

(-1.2, 0.5)

H2 2017–H2 2020

-4.7**

(-7.4, -1.9)

    

Doripenem, IV (g)

0.41

0.12

-5.7

(-11.6, 0.6)

H1 2011–H1 2015

-19.4**

(-29.2, -8.4)

H1 2015–H2 2020

5.8

(-2.1, 14.2)

    

Ertapenem, IV (g)

11.43

9.22

-1.5***

(-1.9, -1.0)

        

Imipenem, IV (g)

10.7

0.89

-13.5***

(-15.2, -11.8)

H1 2011–H1 2016

-18.8***

(-21.0, -16.5)

H1 2016–H2 2020

-7.3***

(-10.3, -4.3)

    

Meropenem, IV (g)

28.5

27.8

-0.1

(-1.2, 1.0)

H1 2011–H1 2016

3.7***

(2.1, 5.3)

H1 2016–H1 2020

-4.1***

(-5.8, -2.4)

    

Quinolones4

426.4

244.6

-2.9***

(-3.6, -2.2)

H1 2011–H1 2015

-6.3***

(-7.5, -5.0)

H1 2015–H2 2020

-0.4

(-1.2, 0.4)

    

Ciprofloxacin, IV (g)

8.6

3.1

-5.3

(-10.4, 0.1)

H1 2011–H2 2016

-3.8***

(-4.9, -2.7)

H2 2016–H1 2018

2.8

(-20.2, 32.4)

H1 2018–H2 2019

-19.1

(-37.2, 4.2)

H2 2019–H2 2020

-2.8

(-25.8, 27.5)

Ciprofloxacin, PO (g)

366.9

164.1

-4.2***

(-4.8, -3.5)

H1 2011–H2 2014

-7.3***

(-8.8, -5.8)

H2 2014–H2 2020

-2.3***

(-3.0, -1.6)

    

Levofloxacin, IV and PO (g)

42.5

76.0

3.2**

(1.3, 5.1)

H1 2011–H1 2017

0.2

(-1.7, 2.1)

H1 2017–H2 2020

8.6**

(4.1, 13.3)

    

Moxifloxacin, IV and PO (g)

8.4

1.4

-8.4***

(-11.2, -5.6)

H1 2011–H2 2015

-12.3***

(-16.7, -7.8)

H2 2015–H2 2020

-4.8*

(-8.8, -0.6)

    

Beta-lactam/beta-lactamse inhibitors5

86.0

126.1

2.2***

(1.8, 2.5)

H1 2011– H2 2013

3.9***

(2.5, 5.4)

H2 2013–H2 2020

1.5***

(1.3, 1.8)

    

Amoxicillin-clavulanate, IV (g)

41.8

62.9

2.6***

(2.3, 2.9)

        

Piperacillin-tazobactam, IV (g)

44.2

63.5

1.9***

(1.3, 2.5)

H1 2011–H1 2015

6.9***

(4.0, 10.0)

H1 2015–H2 2020

0.6**

(0.3, 0.9)

    

Others

           

Cefepime, IV (g)

16.0

7.9

-4.3

(-9.5, 1.2)

H1 2011–H2 2015

-2.4*

(-4.2, -0.6)

H2 2015–H1 2018

3.7

(-3.5, 11.4)

H1 2018–H2 2019

-22.6

(-43.4, 5.8)

H2 2019–H2 2020

-1.1

(-29.5, 38.6)

Colistin, IV (million units)

0.66

0.1

-8.6*

(-15.1, -1.6)

H1 2011–H1 2013

22.9

(-13.5, 74.4)

H1 2013–H2 2020

-15.5***

(-18.9, -12)

    

Polymyxin B, IV (g)

1.8

0.4

-9.1***

(-13.3, -4.8)

H1 2011–H1 2013

14.4*

(2.5, 27.6)

H1 2013–H2 2019

-9.9***

(-11.5, -8.2)

H2 2019–H2 2020

-39.3*

(-60.5, -6.9)

-

-

Tigecycline, IV (g)

0.9

1.1

1.1

(-0.5, 2.8)

        

Linezolid, IV and PO (g)

2.9

2.6

-0.3

(-3.4, 2.8)

H1 2011–H1 2018

-7.8***

(-9.9, -5.7)

H1 2018–

H2 2020

24.1**

(10.9, 38.8)

    

Daptomycin, IV (g)

0.9

2.8

6.9***

(5.1, 8.7)

        

Vancomycin IV (g)

27.8

24.6

-0.8

(-3.4, 1.8)

H1 2011–H1 2012

2.4

(-9.5, 15.9)

H1 2012–

H4 2013

-7.7

(-18.3, 4.2)

H4 2013–H1 2015

4.2

(-7.7, 17.7)

H1 2015–H4 2020

-0.8*

(-1.4, -0.2)

  1. * p < 0.05; ** p < 0.01; ***p < 0.001
  2. CI: confidence interval, DDDs: daily defined doses, Q: quarter, QPC: quarterly percentage change, AQPC: average quarterly percentage change, IV: intravenous, PO: oral
  3. 1Anti-pseudomonal antibiotics comprise cefepime, ceftazidime, ciprofloxacin, colistin, doripenem, imipenem, meropenem, levofloxacin, piperacillin-tazobactam and polymyxin B. 2Third generation cephalosporins comprise ceftazidime and ceftriaxone. 3Carbapenems comprise ertapenem, imipenem, meropenem and doripenem. 4Quinolones comprise ciprofloxacin, levofloxacin and moxifloxacin. 5Beta-lactam/beta-lactamase inhibitors comprise amoxicillin-clavulanate and piperacillin-tazobactam
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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