Antibiotic use and resistance in hospitals: time-series analysis strategy for determining and prioritising interventions

AIMS Antibiotic resistance is a global public health threat. There is sufficient evidence demonstrating the cause-effect relationship between antibiotic use and the development of hospital-acquired infections. However, it is unclear how the data on the relationship between antibiotic use, infection control practices and incidence of hospital-acquired infections can be used to inform daily clinical practice.

Method and results
Pubmed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) databases, from inception until 30 May 2019 were searched. Studies with time-series analysis that have modelled the impact of hospital antibiotic use and infection control practices on the incidence of hospital-acquired resistant infections were considered and of 1327 records screened, 15 studies were eligible and included in this review.

Conclusion
The article outlines how the use of time series analysis can form the basis for a framework to develop strategies to intervene in order to tackle the problem of antibiotic use and resistance. Non-linear time-series analysis can provide a valuable tool to inform hospital antibiotic policies through identifying quantitative targets for optimising antibiotic use and controlling resistance.