Surveillance of Antimicrobial Consumption
In Hospital Sector
2023 Full Year

Key Points

• The median rate of antimicrobial consumption in 42 participating acute hospitals in Ireland in 2023 was 71.8 defined daily doses (DDD) per 100 bed days used (BDU), ranging from 20.9 to 109.2 DDD per 100 BDU. This represents a slight increase from 68.1 DDD per 100 BDU in 2022. Similarly, the mean consumption also increased, rising from 72.6 DDD per 100 BDU in 2022 to 76.8 DDD per 100 BDU in 2023.

• There was a slight increase in the consumption of penicillins, other beta-lactams, macrolides, glycopeptides, imidazoles, and nitrofurans. In contrast, a slight decrease was observed in the consumption of sulfonamides and trimethoprim.

• Penicillins were the most consumed ATC4 group, accounting for more than half of the antibiotic consumption in the hospital sector. Among penicillins, “combinations of penicillins, including beta-lactamase inhibitors (J01CR)” were the highest consumed group, with 23.8 DDD per 100 BDU, up from 23.5 DDD per 100 BDU in 2022. This was followed by “beta-lactamase-resistant penicillins (J01CF),” whose consumption increased from 8.0 DDD per 100 BDU in 2022 to 8.6 DDD per 100 BDU in 2023. Consumption of penicillins with an extended spectrum and beta-lactamase-sensitive penicillins also increased slightly compared to 2022 levels.

• Carbapenem consumption remained relatively stable over the last three years, recorded at 2.4 DDD per 100 BDU in 2023. Conversely, the consumption of second and third-generation cephalosporins has been increasing steadily over the past five years.

Methodology

Background

Using a protocol developed in conjunction with clinical pharmacists, antimicrobial consumption data were extracted from appropriate hospital computer systems that record data on dispensed drugs. At the HPSC, the data from individual hospitals were converted to standardised units of doses. Only consumption relating to inpatients were taken further for rate calculation. HPSC’s web-based analysis tool, MicroB was used for data management.

In this report the Anatomical Therapeutic Chemical (ATC) index is used to classify all drugs used in human medicine into a hierarchical system with five levels. Each systemic antimicrobial substance in conjunction with the route of administration (oral or intravenous) is given a defined daily dose (DDD), which is the assumed average maintenance dose per day for a drug used for its main indication in adults. More information on ATC/DDD Methodology can be found on WHO’s website.

Hospital activity data (bed days used) are obtained from the Business Intelligence Unit within Health Service Executive and consumption rates are expressed as DDD per 100 Bed Days Use for acute inpatient antibiotic consumption. Acute inpatient means that data on antibiotics dispensed to outpatients, day cases and external facilities are excluded.

Limitations

The main limitation for the ATC-DDD system is that the quantities of antimicrobials refer to the usual dose that would be prescribed for adults. Many hospitals participating in this surveillance programme provide maternity services and/or paediatric care, therefore there is an inherent bias in the system. A further limitation with the ATC-DDD system is that the measure is for the main indication only, but a single drug can be used to treat several different conditions. Additionally the rates for an individual hospital may vary due to changes in case-mix, guidelines for the optimal dosage regimen of an antibiotic, and overall hospital activity levels.

The consumption data are based on the volume of antimicrobial drugs supplied to inpatient areas by hospital pharmacies. The data are not based on individual prescriptions and do not measure the appropriateness of antimicrobial therapy. Thus a hospital may report a high rate of antimicrobial consumption, but this rate may be appropriate to the specific patient population served by that hospital.

Methodological Changes

Starting from 2017, returned antimicrobials to the dispensary are subtracted from the overall consumption rates. For the 2017 Q1 and Q2 data, this has resulted in a decrease of the overall rate by 1.5-2% for the mean and median values of the major classes of drugs, with decreases to the total anti-bacterial consumption for individual hospitals ranging from 0% to 9%. Additional stewardship or minor methodological changes may have also occurred. Additionally, this report uses the ATC/DDD calculation method which was updated in 2019. Therefore, figures in this report will be different from prior reports, which predated these methodological changes.

Interpretation of Boxplots

The box represents the the interquartile range (IQR), meaning the bottom and top of the box represents 25th and 75th percentile (the lower and upper quartiles, respectively). The band near the middle of the box is the 50th percentile, the median. The ends of the whiskers represent the lowest data point still within 1.5 times the IQR of the lower quartile, and the highest data point still within 1.5 times the IQR of the upper quartile. Any data point not included between the whiskers is plotted as an outlier with a dot.

Box plots are used to display differences between categories (in this case hospitals) without making any assumptions of the underlying statistical distribution. They help to indicate the degree of dispersion (spread) and skewness in the data, and identify outliers.

Main Results

Table 1: Antimicrobial Consumption in the Last 5 Years

	2019	2020	2021	2022	2023
National Median	77.4	77.4	70.4	68.1	71.8
National Minimum	28.9	20.0	25.8	22.9	20.9
National Maximum	101.5	98.8	111.7	118.2	109.2
National Mean	76.5	73.2	71.6	72.6	76.8

Figure 1: Boxplot of Antimicrobial Consumption by Hospitals in the Last 10 Years

Table 2: Antimicrobial Consumption in the Last 5 Years by ATC-3 Groups

ATC-3 Name	2019	2020	2021	2022	2023
J01C Penicillins	37.3	35.4	34.9	35.8	37.2
J01D Cephalosporins, Monobactams and Carbapenems	9.0	9.6	10.0	10.0	11.5
J01E Sulfonamides and Trimethoprims	2.9	2.5	2.8	2.9	2.6
J01F Macrolides, Lincosamides and Streptogramins	9.4	8.4	7.2	7.7	8.1
J01G Aminoglycosides	3.4	3.1	2.8	2.7	2.8
J01M Quinolones	3.2	2.7	2.5	2.4	2.4
J01X Glycopeptides, Imidazoles and Nitrofurans	8.2	8.2	8.1	7.9	8.4
Other Antimicrobials	3.1	3.3	3.3	3.2	3.8

Figure 2: Antimicrobial Consumption in the Last 10 Years by ATC-3 Groups

Table 3: Penicillin Consumption in the Last 5 Years by ATC-4 Groups

ATC-4 Name	2019	2020	2021	2022	2023
J01CA Penicillins with Extended Spectrum	2.4	2.0	1.9	2.1	2.5
J01CE Beta-lactamase Sensitive Penicillins	3.5	2.8	2.2	2.1	2.3
J01CF Beta-lactamase Resistant Penicillins	8.8	8.4	8.5	8.0	8.6
J01CR Combinations of Penicillins	22.7	22.2	22.2	23.5	23.8

Figure 3: Penicillin Consumption in the Last 10 Years by ATC-4 Groups

Table 4: Other Beta Lactam Consumption in the Last 5 Years by ATC-4 Groups

ATC-4 Name	2019	2020	2021	2022	2023
J01DB First-Generation Cephalosporins	0.6	0.7	0.7	0.8	0.9
J01DC Second-Generation Cephalosporins	2.9	3.0	3.0	3.0	3.5
J01DD Third-Generation Cephalosporins	3.1	3.3	3.4	3.4	3.9
J01DE Fourth-Generation Cephalosporins	0.0	0.0	0.0	0.0	0.0
J01DF Monobactams	0.5	0.5	0.6	0.6	0.8
J01DH Carbapenems	2.0	2.1	2.3	2.2	2.4
J01DI Other Cephalosporins	0.1	0.1	0.0	0.0	0.1

Figure 4: Other Beta Lactam Consumption in the Last 10 Years by ATC-4 Groups

Results by Hospitals

Beaumont Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	78.3	77.4	28.9	101.5	84.7	59.4	95.2
2020	77.0	77.4	20.0	98.8	78.7	56.7	92.0
2021	87.7	70.4	25.8	111.7	79.9	53.9	94.7
2022	69.3	68.1	22.9	118.2	77.7	62.6	89.4
2023	90.4	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Cappagh National Orthopaedic Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	28.9	77.4	28.9	101.5	38.5	28.9	67.8
2020	20.0	77.4	20.0	98.8	30.8	20.0	63.3
2021	51.1	70.4	25.8	111.7	34.6	25.8	68.9
2022	51.1	68.1	22.9	118.2	42.7	22.9	65.0
2023	49.1	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Cavan General Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	101.5	77.4	28.9	101.5	79.9	47.9	101.5
2020	98.8	77.4	20.0	98.8	79.2	39.0	98.8
2021	88.4	70.4	25.8	111.7	72.8	38.0	111.7
2022	84.3	68.1	22.9	118.2	70.9	34.6	118.2
2023	92.9	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Children’s University Hospital, Temple St

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	46.7	77.4	28.9	101.5	38.5	28.9	67.8
2020	28.4	77.4	20.0	98.8	30.8	20.0	63.3
2021	34.8	70.4	25.8	111.7	34.6	25.8	68.9
2022	57.6	68.1	22.9	118.2	42.7	22.9	65.0
2023	59.9	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Connolly Hospital, Blanchardstown

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	77.5	77.4	28.9	101.5	79.9	47.9	101.5
2020	76.8	77.4	20.0	98.8	79.2	39.0	98.8
2021	71.3	70.4	25.8	111.7	72.8	38.0	111.7
2022	67.3	68.1	22.9	118.2	70.9	34.6	118.2
2023	88.9	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Coombe Women and Infants University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	38.6	77.4	28.9	101.5	38.5	28.9	67.8
2020	34.2	77.4	20.0	98.8	30.8	20.0	63.3
2021	34.4	70.4	25.8	111.7	34.6	25.8	68.9
2022	34.2	68.1	22.9	118.2	42.7	22.9	65.0
2023	34.3	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Cork University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	77.3	77.4	28.9	101.5	84.7	59.4	95.2
2020	79.4	77.4	20.0	98.8	78.7	56.7	92.0
2021	69.9	70.4	25.8	111.7	79.9	53.9	94.7
2022	74.3	68.1	22.9	118.2	77.7	62.6	89.4
2023	83.3	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Ennis Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	66.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	63.2	77.4	20.0	98.8	79.2	39.0	98.8
2021	51.4	70.4	25.8	111.7	72.8	38.0	111.7
2022	55.1	68.1	22.9	118.2	70.9	34.6	118.2
2023	61.9	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Kilkreene Orthorpaedic Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	45.8	77.4	28.9	101.5	38.5	28.9	67.8
2020	22.5	77.4	20.0	98.8	30.8	20.0	63.3
2021	38.1	70.4	25.8	111.7	34.6	25.8	68.9
2022	61.5	68.1	22.9	118.2	42.7	22.9	65.0
2023	59.2	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Letterkenny University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	92.6	77.4	28.9	101.5	79.9	47.9	101.5
2020	84.3	77.4	20.0	98.8	79.2	39.0	98.8
2021	82.6	70.4	25.8	111.7	72.8	38.0	111.7
2022	69.9	68.1	22.9	118.2	70.9	34.6	118.2
2023	89.6	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Mater Misericordiae University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	83.8	77.4	28.9	101.5	84.7	59.4	95.2
2020	83.0	77.4	20.0	98.8	78.7	56.7	92.0
2021	82.7	70.4	25.8	111.7	79.9	53.9	94.7
2022	82.2	68.1	22.9	118.2	77.7	62.6	89.4
2023	85.2	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Mayo General Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	79.8	77.4	28.9	101.5	79.9	47.9	101.5
2020	78.8	77.4	20.0	98.8	79.2	39.0	98.8
2021	75.5	70.4	25.8	111.7	72.8	38.0	111.7
2022	70.9	68.1	22.9	118.2	70.9	34.6	118.2
2023	71.8	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Mercy University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	76.1	77.4	28.9	101.5	79.9	47.9	101.5
2020	81.2	77.4	20.0	98.8	79.2	39.0	98.8
2021	79.5	70.4	25.8	111.7	72.8	38.0	111.7
2022	83.9	68.1	22.9	118.2	70.9	34.6	118.2
2023	87.2	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Midland Regional Hospital, Mullingar

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	79.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	77.7	77.4	20.0	98.8	79.2	39.0	98.8
2021	74.2	70.4	25.8	111.7	72.8	38.0	111.7
2022	69.0	68.1	22.9	118.2	70.9	34.6	118.2
2023	79.9	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Midland Regional Hospital, Portlaoise

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	93.3	77.4	28.9	101.5	79.9	47.9	101.5
2020	80.8	77.4	20.0	98.8	79.2	39.0	98.8
2021	82.6	70.4	25.8	111.7	72.8	38.0	111.7
2022	89.8	68.1	22.9	118.2	70.9	34.6	118.2
2023	98.4	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Midland Regional Hospital, Tullamore

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	82.8	77.4	28.9	101.5	79.9	47.9	101.5
2020	79.2	77.4	20.0	98.8	79.2	39.0	98.8
2021	72.8	70.4	25.8	111.7	72.8	38.0	111.7
2022	81.1	68.1	22.9	118.2	70.9	34.6	118.2
2023	85.9	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Naas General Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	93.8	77.4	28.9	101.5	79.9	47.9	101.5
2020	87.7	77.4	20.0	98.8	79.2	39.0	98.8
2021	100.4	70.4	25.8	111.7	72.8	38.0	111.7
2022	118.2	68.1	22.9	118.2	70.9	34.6	118.2
2023	109.2	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

National Maternity Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	33.1	77.4	28.9	101.5	38.5	28.9	67.8
2020	28.7	77.4	20.0	98.8	30.8	20.0	63.3
2021	32.3	70.4	25.8	111.7	34.6	25.8	68.9
2022	33.6	68.1	22.9	118.2	42.7	22.9	65.0
2023	35.1	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Nenagh Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	53.1	77.4	28.9	101.5	79.9	47.9	101.5
2020	52.9	77.4	20.0	98.8	79.2	39.0	98.8
2021	63.7	70.4	25.8	111.7	72.8	38.0	111.7
2022	49.4	68.1	22.9	118.2	70.9	34.6	118.2
2023	50.0	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Our Lady’s Children’s Hospital, Crumlin

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	67.8	77.4	28.9	101.5	38.5	28.9	67.8
2020	63.3	77.4	20.0	98.8	30.8	20.0	63.3
2021	68.9	70.4	25.8	111.7	34.6	25.8	68.9
2022	65.0	68.1	22.9	118.2	42.7	22.9	65.0
2023	64.8	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Our Lady’s Hospital, Navan

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	86.0	77.4	28.9	101.5	79.9	47.9	101.5
2020	86.4	77.4	20.0	98.8	79.2	39.0	98.8
2021	111.7	70.4	25.8	111.7	72.8	38.0	111.7
2022	107.2	68.1	22.9	118.2	70.9	34.6	118.2
2023	90.7	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Our Lady of Lourdes Hospital, Drogheda

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	79.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	79.1	77.4	20.0	98.8	79.2	39.0	98.8
2021	75.5	70.4	25.8	111.7	72.8	38.0	111.7
2022	78.9	68.1	22.9	118.2	70.9	34.6	118.2
2023	87.6	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Portiuncula Hospital, Ballinasloe

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	95.5	77.4	28.9	101.5	79.9	47.9	101.5
2020	81.6	77.4	20.0	98.8	79.2	39.0	98.8
2021	73.6	70.4	25.8	111.7	72.8	38.0	111.7
2022	82.3	68.1	22.9	118.2	70.9	34.6	118.2
2023	89.1	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Roscommon County Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	52.1	77.4	28.9	101.5	79.9	47.9	101.5
2020	39.0	77.4	20.0	98.8	79.2	39.0	98.8
2021	45.5	70.4	25.8	111.7	72.8	38.0	111.7
2022	47.5	68.1	22.9	118.2	70.9	34.6	118.2
2023	44.4	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Rotunda Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	31.4	77.4	28.9	101.5	38.5	28.9	67.8
2020	25.5	77.4	20.0	98.8	30.8	20.0	63.3
2021	25.8	70.4	25.8	111.7	34.6	25.8	68.9
2022	30.4	68.1	22.9	118.2	42.7	22.9	65.0
2023	28.3	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Royal Victoria Eye and Ear Hospital, Dublin

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	47.9	77.4	28.9	101.5	38.5	28.9	67.8
2020	40.5	77.4	20.0	98.8	30.8	20.0	63.3
2021	40.1	70.4	25.8	111.7	34.6	25.8	68.9
2022	56.2	68.1	22.9	118.2	42.7	22.9	65.0
2023	40.4	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Sligo University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	61.3	77.4	28.9	101.5	84.7	59.4	95.2
2020	56.7	77.4	20.0	98.8	78.7	56.7	92.0
2021	58.7	70.4	25.8	111.7	79.9	53.9	94.7
2022	64.4	68.1	22.9	118.2	77.7	62.6	89.4
2023	68.7	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

South Infirmary/Victoria University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	47.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	53.2	77.4	20.0	98.8	79.2	39.0	98.8
2021	54.6	70.4	25.8	111.7	72.8	38.0	111.7
2022	44.7	68.1	22.9	118.2	70.9	34.6	118.2
2023	56.0	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

South Tipperary General Hospital, Clonmel

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	95.7	77.4	28.9	101.5	79.9	47.9	101.5
2020	85.3	77.4	20.0	98.8	79.2	39.0	98.8
2021	84.4	70.4	25.8	111.7	72.8	38.0	111.7
2022	96.6	68.1	22.9	118.2	70.9	34.6	118.2
2023	91.2	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St Columcille’s Hospital, Loughlinstown

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	47.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	40.9	77.4	20.0	98.8	79.2	39.0	98.8
2021	38.0	70.4	25.8	111.7	72.8	38.0	111.7
2022	34.6	68.1	22.9	118.2	70.9	34.6	118.2
2023	35.3	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St James’s Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	88.8	77.4	28.9	101.5	84.7	59.4	95.2
2020	90.5	77.4	20.0	98.8	78.7	56.7	92.0
2021	94.7	70.4	25.8	111.7	79.9	53.9	94.7
2022	89.4	68.1	22.9	118.2	77.7	62.6	89.4
2023	92.7	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St John’s Hospital, Limerick

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	69.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	63.1	77.4	20.0	98.8	79.2	39.0	98.8
2021	53.6	70.4	25.8	111.7	72.8	38.0	111.7
2022	62.9	68.1	22.9	118.2	70.9	34.6	118.2
2023	60.1	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St Luke’s Hospital, Kilkenny

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	62.9	77.4	28.9	101.5	79.9	47.9	101.5
2020	47.8	77.4	20.0	98.8	79.2	39.0	98.8
2021	46.3	70.4	25.8	111.7	72.8	38.0	111.7
2022	66.5	68.1	22.9	118.2	70.9	34.6	118.2
2023	83.7	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St Luke’s Hospital, Rathgar

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	31.0	77.4	28.9	101.5	38.5	28.9	67.8
2020	30.3	77.4	20.0	98.8	30.8	20.0	63.3
2021	27.0	70.4	25.8	111.7	34.6	25.8	68.9
2022	22.9	68.1	22.9	118.2	42.7	22.9	65.0
2023	20.9	71.8	20.9	109.2	39.1	20.9	66.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St Michael’s Hospital, Dun Laoghaire

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	80.6	77.4	28.9	101.5	79.9	47.9	101.5
2020	82.2	77.4	20.0	98.8	79.2	39.0	98.8
2021	67.4	70.4	25.8	111.7	72.8	38.0	111.7
2022	64.5	68.1	22.9	118.2	70.9	34.6	118.2
2023	70.2	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

St Vincent’s University Hospital, Elm Park

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	85.6	77.4	28.9	101.5	84.7	59.4	95.2
2020	77.0	77.4	20.0	98.8	78.7	56.7	92.0
2021	80.4	70.4	25.8	111.7	79.9	53.9	94.7
2022	76.2	68.1	22.9	118.2	77.7	62.6	89.4
2023	78.1	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Tallaght University Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	79.2	77.4	28.9	101.5	84.7	59.4	95.2
2020	77.9	77.4	20.0	98.8	78.7	56.7	92.0
2021	79.5	70.4	25.8	111.7	79.9	53.9	94.7
2022	64.4	68.1	22.9	118.2	77.7	62.6	89.4
2023	67.4	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

University Hospital Kerry, Tralee

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	75.5	77.4	28.9	101.5	79.9	47.9	101.5
2020	82.4	77.4	20.0	98.8	79.2	39.0	98.8
2021	69.8	70.4	25.8	111.7	72.8	38.0	111.7
2022	73.0	68.1	22.9	118.2	70.9	34.6	118.2
2023	71.6	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

University Hospital Limerick

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	85.6	77.4	28.9	101.5	84.7	59.4	95.2
2020	78.0	77.4	20.0	98.8	78.7	56.7	92.0
2021	75.9	70.4	25.8	111.7	79.9	53.9	94.7
2022	79.1	68.1	22.9	118.2	77.7	62.6	89.4
2023	82.6	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

University Hospital Waterford

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	91.0	77.4	28.9	101.5	84.7	59.4	95.2
2020	83.4	77.4	20.0	98.8	78.7	56.7	92.0
2021	72.5	70.4	25.8	111.7	79.9	53.9	94.7
2022	83.4	68.1	22.9	118.2	77.7	62.6	89.4
2023	87.0	71.8	20.9	109.2	84.3	44.0	102.9

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Wexford General Hospital

Table 5: Antimicrobial Consumption in the Last 5 Years (DDD per 100 BDU) in the Hospital

Year	Rate	National Median	National Minimum	National Maximum	Hospital Type Median	Hospital Type Minimum	Hospital Type Maximum
2019	92.7	77.4	28.9	101.5	79.9	47.9	101.5
2020	87.4	77.4	20.0	98.8	79.2	39.0	98.8
2021	70.9	70.4	25.8	111.7	72.8	38.0	111.7
2022	84.4	68.1	22.9	118.2	70.9	34.6	118.2
2023	84.3	71.8	20.9	109.2	84.0	35.3	109.2

Figure 5: Boxplot of Antimicrobial Consumption in the Hospital Group in the Last 10 Years

Appendices

Table 6: List of Participating Hospitals and Their Hospital Category

Hospital Name	Hospital Type Category	Hospital Group
Beaumont Hospital	Tertiary	Dublin North East
Cappagh National Orthopaedic Hospital	Specialist	Dublin East
Cavan General Hospital	General	Dublin North East
Children's University Hospital, Temple St	Specialist	Paediatric
Connolly Hospital, Blanchardstown	General	Dublin North East
Coombe Women and Infants University Hospital	Specialist	Dublin Midlands
Cork University Hospital	Tertiary	South South West
Ennis Hospital	General	Midwest
Galway University Hospitals	Tertiary	West North West
Kilkreene Orthorpaedic Hospital, Co. Kilkenny	Specialist	South South West
Letterkenny University Hospital	General	West North West
Louth County Hospital, Dundalk	General	Dublin North East
Mallow General Hospital	General	South South West
Mater Misericordiaie University Hospital	Tertiary	Dublin East
Mayo General Hospital, Castlebar	General	West North West
Mercy University Hospital	General	South South West
Midland Regional Hospital, Mullingar	General	Dublin East
Midland Regional Hospital, Portlaoise	General	Dublin Midlands
Midland Regional Hospital, Tullamore	General	Dublin Midlands
Naas General Hospital	General	Dublin Midlands
National Maternity Hospital, Holles Street	Specialist	Dublin East
Nenagh Hospital	General	Midwest
Our Lady of Lourdes Hospital, Drogheda	General	Dublin North East
Our Lady's Children's Hospital, Crumlin	Specialist	Paediatric
Our Lady's Hospital, Navan	General	Dublin East
Portiuncula Hospital, Ballinasloe	General	West North West
Roscommon County Hospital	General	West North West
Rotunda Hospital	Specialist	Dublin North East
Royal Victoria Eye and Ear Hospital, Dublin	Specialist	Dublin East
Sligo University Hospital	Tertiary	West North West
South Infirmary/Victoria University Hospital, Cork	General	South South West
South Tipperary General Hospital, Clonmel	General	South South West
St Columcille's Hospital, Loughlinstown	General	Dublin East
St James's Hospital	Tertiary	Dublin Midlands
St John's Hospital, Limerick	General	Midwest
St Luke's Hospital, Kilkenny	General	Dublin East
St Luke's Hospital, Rathgar	Specialist	Dublin Midlands
St Michael's Hospital, Dun Laoghaire	General	Dublin East
St Vincent's University Hospital, Elm Park	Tertiary	Dublin East
Tallaght Hospital	Tertiary	Dublin Midlands
University Hospital Kerry, Tralee	General	South South West
University Hospital Limerick	Tertiary	Midwest
University Hospital Waterford	Tertiary	South South West
Wexford General Hospital	General	Dublin East

Acknowledgements

Sincere thanks to all hospital pharmacists for their continued support for hospital antimicrobial consumption surveillance and for providing data for this report.