scholarly journals A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Ralalicia Limato ◽  
Erni J Nelwan ◽  
Manzilina Mudia ◽  
Justin de Brabander ◽  
Helio Guterres ◽  
...  
Keyword(s):  
Antibiotic Prescription ◽  
Point Prevalence ◽  
High Rate ◽  
Antibiotic Prescribing ◽  
Prevalence Survey ◽  
Hospital Acquired Infections ◽  
Point Prevalence Survey ◽  
Hospital Acquired ◽  
Third Generation Cephalosporins

Abstract Background The global emergence of antimicrobial resistance is driven by antibiotic misuse and overuse. However, systematic data in Indonesian hospitals to adequately inform policy are scarce. Objectives To evaluate patterns and quality indicators of antibiotic prescribing in six general hospitals in Jakarta, Indonesia. Methods We conducted a hospital-wide point prevalence survey (PPS) between March and August 2019, using Global-PPS and WHO-PPS protocols. The analysis focused on antibacterials (antibiotics) for systemic use. Results Of 1602 inpatients, 993 (62.0%) received ≥1 antimicrobial. Of 1666 antimicrobial prescriptions, 1273 (76.4%) were antibiotics. Indications comprised community-acquired infections (42.6%), surgical prophylaxis (22.6%), hospital-acquired infections (18.5%), medical prophylaxis (9.6%), unknown (4.6%) and other (2.1%). The most common reasons for antibiotic prescribing were pneumonia (27.7%), skin and soft tissue infections (8.3%), and gastrointestinal prophylaxis (7.9%). The most prescribed antibiotic classes were third-generation cephalosporins (44.3%), fluoroquinolones (13.5%), carbapenems (7.4%), and penicillins with β-lactamase inhibitor (6.8%). According to the WHO AWaRe classification, Watch antibiotics accounted for 67.4%, followed by 28.0% Access and 2.4% Reserve. Hospital antibiotic guidelines were not available for 28.1% of prescriptions, and, where available, guideline compliance was 52.2%. Reason for the antibiotic prescription, stop/review date and planned duration were poorly documented. Culture-guided prescriptions comprised 8.1% of community-acquired infections and 26.8% of hospital-acquired infections. Conclusions Our data indicate a high rate of empirical use of broad-spectrum antibiotics in Indonesian hospitals, coupled with poor documentation and guideline adherence. The findings suggest important areas for antimicrobial stewardship interventions.

scholarly journals A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals

2021 ◽  
Author(s):  
Ralalicia Limato ◽  
Erni J. Nelwan ◽  
Manzilina Mudia ◽  
Justin de Brabander ◽  
Helio Guterres ◽  
...  
Keyword(s):  
Point Prevalence ◽  
High Rate ◽  
Antibiotic Prescribing ◽  
Gastrointestinal Infections ◽  
Prevalence Survey ◽  
Hospital Acquired Infection ◽  
Point Prevalence Survey ◽  
Hospital Acquired ◽  
Third Generation Cephalosporins

SynopsisBackgroundAntibiotic misuse and overuse are a major driver of antimicrobial resistance, but systematic data in Indonesia are scarce.ObjectivesTo evaluate patterns and quality indicators of antibiotic prescribing in six acute-care hospitals in Jakarta, Indonesia.MethodsWe conducted a hospital-wide point prevalence survey (PPS) between March and August 2019, using Global-PPS and WHO-PPS protocols. The analysis focused on antibacterials for systemic use (antibiotics).ResultsOf 1602 inpatients, 993 (62.0%) received ≥1 antimicrobials. Of 1666 antimicrobial prescriptions, 1273 (76.4%) were antibiotics. Most common reasons for prescribing were pneumonia (27.7%), skin and soft tissue infections (8.3%), gastrointestinal prophylaxis (7.9%), and gastrointestinal infections (5.4%). The most common indication was community-acquired infection (42.6%), followed by surgical prophylaxis (22.6%), hospital-acquired infection (18.5%), medical prophylaxis (9.6%), unknown (4.6%) and other indications (2.1%). The most prescribed antibiotic classes were third-generation cephalosporins (44.3%), fluoroquinolones (13.5%), carbapenems (7.4%), penicillins with B-lactamase inhibitor (6.8%) and aminoglycosides (6.0%). According to the WHO AWaRe classification, Watch antibiotics accounted for 67.4%, followed by 28.0% Access, 2.4% Reserve, and 2.2% Unclassified. Reason for prescribing, stop/review date and planned duration were poorly documented. Hospital antibiotic guidelines were not available for 28.1% of prescriptions, and guideline compliance was 52.2% (478/915). Parenteral administration was high (85.1%). Targeted (non-empirical) prescriptions comprised 8.1% (44/542) for community-acquired infections and 26.8% (63/235) for hospital-acquired infections.ConclusionsOur data indicate a high rate of parenteral, empiric use of broad-spectrum antibiotics in Indonesian hospitals, coupled with poor documentation and guideline adherence. The findings suggest important areas for antimicrobial stewardship interventions.

Internal and External Validation of a Computer-Assisted Surveillance System for Hospital-Acquired Infections in a 754-Bed General Hospital in the Netherlands

2016 ◽  
Vol 37 (11) ◽  
pp. 1355-1360 ◽  
Author(s):  
H. Roel A. Streefkerk ◽  
Ivar O. Lede ◽  
John L. V. Eriksson ◽  
Marije G. Meijling ◽  
Conrad P. van der Hoeven ◽  
...  
Keyword(s):  
The Netherlands ◽  
External Validation ◽  
Point Prevalence ◽  
Computer Assisted ◽  
Prevalence Survey ◽  
Internal Validation ◽  
Hospital Acquired Infections ◽  
Point Prevalence Survey ◽  
A Prospective Study ◽  
Hospital Acquired

OBJECTIVETo evaluate a computer-assisted point-prevalence survey (CAPPS) for hospital-acquired infections (HAIs).DESIGNValidation cohort.SETTINGA 754-bed teaching hospital in the Netherlands.METHODSFor the internal validation of a CAPPS for HAIs, 2,526 patients were included. All patient records were retrospectively reviewed in depth by 2 infection control practitioners (ICPs) to determine which patients had suffered an HAI. Preventie van Ziekenhuisinfecties door Surveillance (PREZIES) criteria were used. Following this internal validation, 13 consecutive CAPPS were performed in a prospective study from January to March 2013 to determine weekly, monthly, and quarterly HAI point prevalence. Finally, a CAPPS was externally validated by PREZIES (Rijksinstituut voor Volksgezondheid en Milieu [RIVM], Bilthoven, Netherlands). In all evaluations, discrepancies were resolved by consensus.RESULTSIn our series of CAPPS, 83% of the patients were automatically excluded from detailed review by the ICP. The sensitivity of the method was 91%. The time spent per hospital-wide CAPPS was ~3 hours. External validation showed a negative predictive value of 99.1% for CAPPS.CONCLUSIONSCAPPS proved to be a sensitive, accurate, and efficient method to determine serial weekly point-prevalence HAI rates in our hospital.Infect Control Hosp Epidemiol2016;1–6

scholarly journals 2018. The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Quantity and Quality of Antimicrobial Prescribing for Inpatients with Pneumonia in the Philippines in 2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S677-S677
Author(s):  
Mari Rose Aplasca De los Reyes ◽  
Maria Charmian M Hufano ◽  
Ines Pauwels ◽  
Ann Versporten ◽  
Herman Goossens
Keyword(s):  
Enzyme Inhibitor ◽  
The Philippines ◽  
Community Acquired Pneumonia ◽  
Point Prevalence ◽  
Antibiotic Prescribing ◽  
Prevalence Survey ◽  
Public And Private ◽  
Point Prevalence Survey ◽  
Stewardship Program

Abstract Background Pneumonia is the most common indication for prescription of antibiotics in hospitals in the Philippines. We describe the quality and quantity of antibiotic prescribing for hospitalized pneumonia patients in the Philippines in 2018 (www.global-PPS.com). Methods A point prevalence survey was performed from September to December 2018 in 28 public and private hospitals in Luzon, Mindanao, and Visayas regions. Ward- and patient-level data were collected using a standardized methodology and entered through a web-based application. We analyzed all antibiotic (ATC J01) prescriptions for inpatients with pneumonia. Results Of all hospitalized patients, 16.2% (n = 1516) received one or more antibiotic (J01) for treatment of pneumonia, majority (78.3%) of which were for community-acquired pneumonia (CAP). In adults, the most commonly used antibiotics were azithromycin (19.5%), ceftriaxone (19.0%), and piperacillin/enzyme inhibitor (13.2%) for CAP and meropenem (19.8%), piperacillin/enzyme inhibitor (18.9%), and levofloxacin (8.6%) for healthcare-associated pneumonia (HAP). In neonates and children, cefuroxime was used most often (20.1%) for treatment of CAP, followed by ampicillin (16.7%) and amikacin (15.3%). Children and neonates with HAP were most commonly treated with amikacin (18.7%), meropenem (15.7%), and ampicillin (10.4%). Overall, 16.0% of all antibiotic prescriptions for pneumonia were based on microbiological results, 11.3% for CAP and 33.9% for HAP. Microbiology-based prescriptions were most commonly targeted at ESBL-producing Enterobacteriaceae (8.4%). Further analysis of quality indicators showed that up to 80.0% of all prescriptions for pneumonia were compliant to local guidelines and reason in notes was documented for 81.0% of prescriptions. However, the stop or review date of antibiotic treatment for pneumonia was less documented (27.8%). Conclusion Global-PPS data provided valuable insights into the quantity and quality of antibiotic prescribing for pneumonia inpatients. These results will be fedback to the Department of Health, medical societies, and hospitals for prioritization of targets and policies toward the improvement of the Philippine antimicrobial stewardship program. Disclosures All authors: No reported disclosures.

scholarly journals Point-Prevalence Survey for the Hospital-Acquired Infections in Intensive Care Units of Trauma Center in a Tertiary Care Hospital of Northern India

2021 ◽  
Author(s):  
Sandeep Boora ◽  
Parul Singh ◽  
Arun Verma ◽  
Ashok Chauhan ◽  
Amit Lathwal ◽  
...  
Keyword(s):  
Trauma Center ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Point Prevalence ◽  
Care Hospital ◽  
Prevalence Survey ◽  
Hospital Acquired Infections ◽  
Point Prevalence Survey ◽  
Stewardship Program ◽  
Hospital Acquired

Abstract Background The burden of hospital-acquired infections (HAIs) is all assumption based, and the true burden remains unknown in most countries, particularly in the developing countries where healthcare facilities are suboptimal and knowledge is limited. Methodology This cross-sectional study was conducted at the trauma center of a tertiary care institute from August to September 2019, to assess the burden of HAI and antibiotic resistance pattern of HAI. The total sample size in our study was 105. Our objective was to estimate the point prevalence of HAI and study the associated factors in a tertiary care hospital. Result In this study, the point prevalence of HAI was five to six times higher when compared with that of developed countries. Gram-negative organisms were the predominant bacteria; with Acinetobacter baumannii the most common among them. Conclusion Point-prevalence survey is an important objective of the antimicrobial stewardship program; it will be helpful in controlling antimicrobial resistance and this tool plays a significant role in hospital settings. Our study is quite pertinent to assess the point prevalence of HAI. It will help in knowing the current prevalence and pattern of the HAI. Therefore, as healthcare administrators, we can further decrease the HAI for better patient outcomes in the future.

scholarly journals Multi-centre point-prevalence survey of hospital-acquired infections in Ghana

2019 ◽  
Vol 101 (1) ◽  
pp. 60-68 ◽  
Author(s):  
A-K. Labi ◽  
N. Obeng-Nkrumah ◽  
E. Owusu ◽  
S. Bjerrum ◽  
A. Bediako-Bowan ◽  
...  
Keyword(s):  
Point Prevalence ◽  
Prevalence Survey ◽  
Hospital Acquired Infections ◽  
Point Prevalence Survey ◽  
Hospital Acquired

A point prevalence survey of antibiotic use in four acute-care teaching hospitals utilizing the European Surveillance of Antimicrobial Consumption (ESAC) audit tool

2011 ◽  
Vol 140 (9) ◽  
pp. 1714-1720 ◽  
Author(s):  
M. A. ALDEYAB ◽  
M. P. KEARNEY ◽  
J. C. McELNAY ◽  
F. A. MAGEE ◽  
G. CONLON ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Teaching Hospitals ◽  
Antibiotic Prescribing ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Indication For Treatment

SUMMARYThe objective of this research was to assess current patterns of hospital antibiotic prescribing in Northern Ireland and to determine targets for improving the quality of antibiotic prescribing. A point prevalence survey was conducted in four acute teaching hospitals. The most commonly used antibiotics were combinations of penicillins including β-lactamase inhibitors (33·6%), metronidazole (9·1%), and macrolides (8·1%). The indication for treatment was recorded in 84·3% of the prescribing episodes. A small fraction (3·9%) of the surgical prophylactic antibiotic prescriptions was for >24 h. The results showed that overall 52·4% of the prescribed antibiotics were in compliance with the hospital antibiotic guidelines. The findings identified the following indicators as targets for quality improvement: indication recorded in patient notes, the duration of surgical prophylaxis and compliance with hospital antibiotic guidelines. The results strongly suggest that antibiotic use could be improved by taking steps to address the identified targets for quality improvement.

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