Background Linezolid belongs to a reserve group of antibiotics. In recent years, reports on linezolid resistance in gram-positive cocci have become more frequent. Overuse of linezolid is a relevant factor for resistance development. The objective of this study was to describe current prescription practices of linezolid in German hospitals and identify targets for antimicrobial stewardship interventions. Methods We analyzed all linezolid prescriptions from the datasets of the consecutive national point prevalence surveys performed in German hospitals in 2011 and 2016. In both surveys, data on healthcare-associated infections and antimicrobial use were collected following the methodology of the European Centre for Disease Prevention and Control. Results Overall, the percentage of linezolid among all documented antimicrobials increased significantly from 2011 to 2016 (p < 0.01). In 2011, 0.3% (119 of 41,539) patients received linezolid, in 2016 this proportion was significantly higher (0.4%; 255 of 64,412 patients; p < 0.01). In 2016, intensive care units (ICUs) were the wards most frequently prescribing linezolid. The largest proportion of patients receiving linezolid were non-ICU patients. Roughly 38% of linezolid prescriptions were for treatment of skin/soft tissue and respiratory tract infections. In 2016, linezolid was administered parenterally in 70% (n = 179) of cases. Multivariable analysis showed that the ward specialty ICU posed an independent risk factor, while Northern and Southwestern regions in Germany were independent protective factors for a high rate of linezolid prescriptions. Conclusions In conclusion, we detected potentials for improving linezolid prescription practices in German hospitals. Given the emergence of linezolid resistance, optimization of linezolid use must be a target of future antimicrobial stewardship activities.

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德国急诊医院使用利奈唑胺的情况：两次连续的国家点流行率调查的结果。

背景利奈唑胺属于一组抗生素。近年来，关于革兰氏阳性球菌对利奈唑胺耐药的报道越来越多。利奈唑胺的过度使用是耐药性发展的相关因素。这项研究的目的是描述德国医院中利奈唑胺的现行处方实践，并确定抗微生物药物干预措施的目标。方法我们从2011年和2016年在德国医院进行的全国性点普遍性调查的数据集中分析了所有利奈唑胺处方。在这两次调查中，均按照欧洲疾病预防中心的方法收集了与医疗相关的感染和抗菌药物使用的数据和控制。总体而言，从2011年到2016年，所有已记录的抗菌药物中利奈唑胺的百分比均显着增加（p <0.01）。2011年，接受利奈唑胺治疗的患者为0.3％（41,539名患者中的119名），2016年这一比例显着更高（0.4％; 64,412名患者中的255名; p <0.01）。在2016年，重症监护病房（ICU）是处方利奈唑胺最常用的病房。接受利奈唑胺治疗的患者中，最大比例的是非ICU患者。利奈唑胺处方中约有38％用于治疗皮肤/软组织和呼吸道感染。2016年，利奈唑胺经肠胃外给药的病例占70％（n = 179）。多变量分析表明，病房专科ICU构成了独立的危险因素，而德国北部和西南部地区是利奈唑胺处方率高的独立保护因素。结论总之，我们在德国医院中发现了改善利奈唑胺处方实践的潜力。考虑到利奈唑胺耐药性的出现，优化利奈唑胺的使用必须成为未来抗菌管理活动的目标。