scholarly journals 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S683-S684
Author(s):  
Jenny Hsieh ◽  
Hatim Sati ◽  
Pilar Ramon-Pardo ◽  
Nienke Bruinsma ◽  
Marcelo F. Galas ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Antimicrobial Use ◽  
Feedback Systems ◽  
Prevalence Survey ◽  
Local Capacity ◽  
The Caribbean

Abstract Background Inappropriate use of antimicrobials is one of the core contributors to antimicrobial resistance. While hospitals create high selection pressures on bacteria due to the high quantity and broader spectrum of antibiotics used, information on antimicrobial use at the patient level in the Caribbean is sparse. In response, PAHO implemented a standardized WHO methodology to engage national leaderships, build local capacity, and facilitate the use of data to inform antimicrobial stewardship programs (ASP) in the Caribbean. Methods Point prevalence surveys (PPS) were performed in four acute care hospitals in Barbados, Guyana and Saint Lucia between June and July 2018. Medical records of all inpatients were reviewed to collect information on antibiotic use, indications and use of laboratory services (Figure 1). A hospital questionnaire was used to assess hospital infrastructure, policy and practices, and monitoring and feedback systems (Figure 2). Training on PPS methods and electronic data collection tool in REDCap™ were provided to build local capacity and identify potential ASP leaderships. A standardized data validation, analysis and reporting system was built in R to streamline the process. Results and recommendations were disseminated to national authorities and stakeholders to support hospital and national decision-making and training for healthcare providers (Figure 3). Results A total of 60 physicians, nurses, pharmacists, laboratory technicians, and infection control specialists were trained and participated in the PPS. The survey collected records of 816 patients in which 442 (54%) were females and 374 (46%) were males. In total, 356 (44%) patients received 551 antibiotics. Overall, 300 (75%) of 398 indications for antibiotic use were treatment and 72 (18%) were prophylaxis. A higher use of parenteral antibiotics (79%) was observed compared with oral antibiotics (21%). Antibiotic prescribing patterns differed across hospitals. The most commonly used antibiotics were metronidazole (12%) and amoxicillin/clavulanate (11%). Conclusion The PPS method provided a feasible and effective way to collect baseline data and identify target areas for interventions. Engaging national leaderships and building local capacity offered a sustainable way in optimizing antimicrobial use in resource-limited settings. Disclosures All authors: No reported disclosures.

scholarly journals Antibiotic Use Among Hospitalized Children and Neonates in China: Results From Quarterly Point Prevalence Surveys in 2019

2021 ◽  
Vol 12 ◽  
Author(s):  
Chu-ning Wang ◽  
Jianning Tong ◽  
Bin Yi ◽  
Benedikt D. Huttner ◽  
Yibing Cheng ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Hospitalized Children ◽  
Prevalence Survey ◽  
Common Diagnosis ◽  
Tract Infections ◽  
The Impact

Background: Antimicrobial resistance is a significant clinical problem in pediatric practice in China. Surveillance of antibiotic use is one of the cornerstones to assess the quality of antibiotic use and plan and assess the impact of antibiotic stewardship interventions.Methods: We carried out quarterly point prevalence surveys referring to WHO Methodology of Point Prevalence Survey in 16 Chinese general and children’s hospitals in 2019 to assess antibiotic use in pediatric inpatients based on the WHO AWaRe metrics and to detect potential problem areas. Data were retrieved via the hospital information systems on the second Monday of March, June, September and December. Antibiotic prescribing patterns were analyzed across and within diagnostic conditions and ward types according to WHO AWaRe metrics and Anatomical Therapeutic Chemical (ATC) Classification.Results: A total of 22,327 hospitalized children were sampled, of which 14,757 (66.1%) were prescribed ≥1 antibiotic. Among the 3,936 sampled neonates (≤1 month), 59.2% (n = 2,331) were prescribed ≥1 antibiotic. A high percentage of combination antibiotic therapy was observed in PICUs (78.5%), pediatric medical wards (68.1%) and surgical wards (65.2%). For hospitalized children prescribed ≥1 antibiotic, the most common diagnosis on admission were lower respiratory tract infections (43.2%, n = 6,379). WHO Watch group antibiotics accounted for 70.4% of prescriptions (n = 12,915). The most prescribed antibiotic ATC classes were third-generation cephalosporins (41.9%, n = 7,679), followed by penicillins/β-lactamase inhibitors (16.1%, n = 2,962), macrolides (12.1%, n = 2,214) and carbapenems (7.7%, n = 1,331).Conclusion: Based on these data, overuse of broad-spectrum Watch group antibiotics is common in Chinese pediatric inpatients. Specific interventions in the context of the national antimicrobial stewardship framework should aim to reduce the use of Watch antibiotics and routine surveillance of antibiotic use using WHO AWaRe metrics should be implemented.

scholarly journals 172. Inpatient Antibiotic Prescribing Patterns Using the WHO Access Watch and Reserve (AWaRe) Classification in Okinawa, Japan: A Point Prevalence Survey

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S195-S196
Author(s):  
Payal K Patel ◽  
Naoyuki Satoh ◽  
Masashi Narita ◽  
Yoshiaki Cho ◽  
Yusuke Oshiro ◽  
...  
Keyword(s):  
World Health Organization ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Prescribing Patterns ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Full Time ◽  
Prevalence Survey ◽  
Health Organization

Abstract Background Few studies have been done on inpatient antibiotic use in Japan and antibiotic stewardship programs with dedicated full-time equivalents are rare. We sought to better understand inpatient antibiotic use in Okinawa, Japan. We applied the World Health Organization (WHO) Access, Watch and Reserve (AWaRe) Classification to compare our findings to international literature. Access antibiotics are common front-line antibiotics, Watch antibiotics are high-priority antibiotics with toxicity or resistance concerns, and Reserve antibiotics are last-line treatments for multi-drug resistant infections. Methods A point prevalence study was conducted in five hospitals in Okinawa, Japan on Oct 1, 2020. Physicians conducted chart reviews of all patients receiving intravenous antibiotics. Type of antibiotic, reason for use, duration, and microbiologic data was collected. The primary aim was to evaluate the proportion of patients who received antibiotics on the assessment date; secondary aims were to categorize antibiotics according to indication, class and AWaRe classification. Descriptive statistics were used to derive the distribution of AWaRe Classifications and drug class. Results 1,728 unique patients were included and 504 (29%) received ≥1 antibiotic on the assessment date. A total of 559 antibiotics were used for 504 patients and 22.0% (n=123) were for prophylaxis. Of those receiving antibiotics for treatment (N=436), 385 (88.3%) patients had a documented infection source. The most common indications for antibiotic use were pneumonia (24.2% n=93), urinary tract infection (19.7% n=76), and intraabdominal (17.9% n=69). Overall, 43.1% (n=241) of the antibiotics were categorized Access and 54.4% (n=304) Watch [Figure 1]. Cephalosporins were the most common antibiotic class (56% n=313), followed by β-lactam inhibitors (18% n=106) and narrow penicillins (8.2% n=46) [Figure 2]. Conclusion 29% of inpatients in these 5 Okinawan hospitals were prescribed an antibiotic on the survey date. A majority of antibiotics used fall under the WHO AWaRe Watch classification which are antibiotics that may be more likely to cause resistance. Understanding appropriateness of antibiotics used in this population could inform antibiotic stewardship strategies and reduce antibiotic resistance. Figure 1. Antibiotic Distribution According to World Health Organization (WHO) Access, Watch and Reserve (AWaRe) Classification Figure 2. Antibiotic Distribution by Class in Okinawan Hospitals Disclosures All Authors: No reported disclosures

scholarly journals Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1122
Author(s):  
Nikki D’Arcy ◽  
Diane Ashiru-Oredope ◽  
Omotayo Olaoye ◽  
Daniel Afriyie ◽  
Zainab Akello ◽  
...  
Keyword(s):  
Evidence Base ◽  
Point Prevalence ◽  
Prescribing Patterns ◽  
Public Health Issue ◽  
Antibiotic Prescribing ◽  
Antimicrobial Use ◽  
Global Public Health ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
The Impact

Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base.

scholarly journals A prospective antibiotic point prevalence survey in two primary referral hospitals during and after pilgrims stay in Madinah, Saudi Arabia

2020 ◽  
Vol 19 (2) ◽  
pp. 391-399
Author(s):  
Yaser M. ◽  
Ahmad K. Aljabri ◽  
Faisal N. Alsaadi ◽  
Lamiaa M. Rizk ◽  
Renad Y. Alahmadi ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Antibiotic Therapy ◽  
Prevalence Rate ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Antibiotic Prescribing ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Significant Difference ◽  
Referral Hospitals

Purpose: To assess current patterns of antibiotic use by carrying out two point-prevalence surveys (PPS) in Madinah after the return of hajj pilgrims from Makkah and when Madinah is free from pilgrims. Methods: In September 2016 and November 2016, a prospective PPS was conducted on two separate dates (during the hajj pilgrims stay in Madinah and after they leave). Data on antibiotics use were generated during these two periods. This involved an audit from all the departments of two referral hospitals (King Fahad Hospital (KFH) - 425 beds, and Al Ansar Hospital - 100 beds) of inpatients records. Data were collected using standard forms adapted from the European Centre for Disease Control (ECDC). Results: A total of 675 inpatients were included in PPS; among them, 332 (49.18 %) patients were receiving antibiotic therapy. In September 2016, 168 patients were treated with antibiotics, with a prevalence rate of 50.60 %, whereas, in November 2016, the prevalence rate was 49.40 %. Overall, 198 patients were identified in surgical wards, of which 132 patients (66.6 %) were receiving antibiotic therapy; 121 patients in ICU of which 70 patients (57.8 %) received antibiotics; 13 patients in other wards of which 6 (46.1 %) received antibiotic treatment; and 343 patients in medical wards of which 126 patients (36.7 %) were treated with antibiotics. There was no significant difference in prevalence of antibiotic prescribing between the two surveys (Pearson Chi-square test, p = 0.56) and with regards to patient age between the two surveys (Mann-Whitney U-test, p = 0.32). Conclusion: The results demonstrate that antibiotic use with adherence to hospital guidelines and PPS helps in identifying targets for quality improvement. Moreover, to escalate the prudent use of antibiotics in hospitals, PPS provides a useful tool. Furthermore, this survey provides a background to evaluate antibiotic use by a standardized methodology. Keywords: Point prevalence survey, Antibiotic use, Prescribing practices, Antibiotic resistance, Quality improvement, Antibiotic stewardship, Hajj, Pilgrims

scholarly journals 19. A Global Point Prevalence Survey of Antimicrobial Use in Neonatal Intensive Care Units

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S10-S10
Author(s):  
Pavel Prusakov ◽  
Debra A Goff ◽  
Phillip Wozniak ◽  
Pablo J Sanchez
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
Point Prevalence ◽  
Initial Assessment ◽  
Definitive Treatment ◽  
P Value ◽  
Antimicrobial Use ◽  
Site Location ◽  
Prevalence Survey ◽  
Research Grant

Abstract Background Antimicrobials are one of the most commonly used medications in the NICU. We aimed to gather baseline global data on antimicrobial use to facilitate subsequent antimicrobial stewardship efforts. Methods We conducted a one-day global NICU point prevalence study on July 1, 2019 with a 30-day follow up. Data collection included patient demographics, antimicrobial therapy, site location, antimicrobial stewardship (AS) practices as well as the duration of antimicrobial therapy and in-hospital mortality were recorded. Results Eighty-one NICUs from twenty-eight different countries identified 2,163 admitted patients of which 570 (26%) were prescribed at least one antimicrobial. Three NICUs did not have any patients on antimicrobial therapy, all had less than 20 patients admitted. Level 3 and Level 4 NICUs comprised 51% and 48% respectively. Delivery units comprised 74%, the rest were referral centers. AS programs were in place in 62% of the hospitals and 47% of the units had NICU specific initiatives. Patients were on average 32.5 weeks gestational age (+/-5.3 SD), with birth weight of 1976 grams (+/- 1022 SD), and were 32 days (+/-65 SD) postnatal age at the time of the study. Antibiotics were the most frequently used medication in 92% of patients with 931 antibiotics prescribed on the assessment day. Hospitals with any NICU AS initiative had significantly lower rates of antibiotic utilization compared to NICUs without AS (21% and 32%; p-value: < 0.01). Of those on antibiotic therapy, ampicillin, gentamicin and amikacin were prescribed to 41%, 34%, and 21% of patients respectively. When only definitive treatment was evaluated, vancomycin, amikacin, and meropenem were the highest prescribed antibacterial agents at 25%, 19%, and 19% respectively. At the initial assessment, study participants indicated either 3 or 7 days (37% and 26%) for planned duration. Actual treatment duration for empiric and definitive treatment, was 7 and 14 days (29% and 19%) When comparing patients who had an established treatment course at the time of the initial assessment, the final length of treatment for culture negative sepsis was 7 (IQR:5–10) and culture positive sepsis was 11 days (IQR:10–14; p-value: 0.07). Conclusion Benchmarking global antimicrobial use is crucial for improving NICU-AS practices. Disclosures Pavel Prusakov, PharmD, Merck (Research Grant or Support) Debra A. Goff, PharmD, Merck (Research Grant or Support)

scholarly journals Antimicrobial use across six referral hospitals in Tanzania: a point prevalence survey

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042819
Author(s):  
Jeremiah Seni ◽  
Siana G Mapunjo ◽  
Rachel Wittenauer ◽  
Richard Valimba ◽  
Andy Stergachis ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Referral Hospital ◽  
Antimicrobial Use ◽  
Prevalence Survey ◽  
Regional Referral Hospital ◽  
Point Prevalence Survey ◽  
Referral Hospitals

ObjectiveTo delineate the prevalence and factors associated with antimicrobial use across six referral hospitals in Tanzania using WHO point prevalence survey (PPS) methodology to inform hospital-specific antimicrobial stewardship programmes.DesignCross-sectional analytical study.SettingSix referral hospitals in Tanzania.ParticipantsPatients irrespective of age and gender (n=948) admitted in the six referral hospital wards before 8:00 hours on each day of the survey were included in December 2019. Using the WHO PPS methodology, data on hospitals, wards, patients, antibiotics, and indications for antibiotics were collected.Outcome measuresWe analysed the prevalence of antibiotic use by referral hospital, ward, indication and patient characteristics as the main outcomes. We also described adherence to the Tanzania Standard Treatment Guidelines (STG) and WHO’s AWaRe categorisation of antibiotics.ResultsApproximately 62.3% of inpatients were prescribed antibiotics, predominantly from the Access group of antibiotics (ceftriaxone, metronidazole or ampicillin–cloxacillin). The overall adherence of antibiotic prescriptions to the Tanzania STG was high (84.0%), with the exception of Sekou Toure Regional Referral Hospital (68.0%) and Maweni Regional Referral Hospital (57.8%). The most common indication for antibiotic prescriptions was community-acquired infections (39.8%). Children less than 2 years of age (OR 1.73, 95% CI 1.02 to 2.92, p=0.039); admission to surgical wards (OR 4.90, 95% CI 2.87 to 8.36, p <0.001); and admission to paediatric wards (OR 3.93, 95% CI 2.16 to 7.15, p <0.001) were associated with increased odds of antibiotic use. Only 2 of 591 patients were prescribed antibiotics based on culture and antimicrobial susceptibility testing results.ConclusionsEmpirical use of antibiotics is common, and the Access group of antibiotics is predominantly prescribed in children less than 2 years and patients admitted to surgical and paediatric wards. Lack of utilisation of antimicrobial susceptibility testing services in these hospitals requires urgent interventions. Routine monitoring of antibiotic use is recommended to be part of antibiotic stewardship programmes in Tanzania.

Point Prevalence Survey of Antimicrobial Prescription Patterns in a Pediatric Tertiary-Care Unit in Thailand 2019

2021 ◽  
Vol 104 (9) ◽  
pp. 1476-1482
Keyword(s):  
Antimicrobial Stewardship ◽  
Point Prevalence ◽  
Audit And Feedback ◽  
Antimicrobial Use ◽  
Prospective Audit ◽  
Prevalence Survey ◽  
Prescription Patterns ◽  
Point Prevalence Survey ◽  
Stewardship Program ◽  
Prospective Audit And Feedback

Background: Surveillance data is an essential part of antimicrobial stewardship programs (ASP). Objective: To describe and compare prescription patterns of antibiotics after a 3-years implementation of an ASP using prospective audit and feedback. Materials and Methods: The authors conducted a point prevalence survey (PPS) of antibiotic prescriptions at a 200-bed pediatric unit at King Chulalongkorn Memorial Hospital. A standardized study protocol from the Global Antimicrobial Resistance, Prescribing, and the Efficacy in Neonates and Children (GARPEC) project was used. The authors reviewed medical charts of hospitalized children of less than 18 years of age, using a point prevalence method on the 15 of February, May, August, and November 2019. Endpoints measures included rate of antimicrobial prescriptions and type of antimicrobial use, stratified by neonatal and pediatric ward types. Rate of antimicrobial prescriptions will be compared with historical data form PPS in the same institute collected in 2016. Results: In 2019, the medical records of 269 neonates and 409 children hospitalized were reviewed. The proportion of children receiving antibiotics in neonatal units overall was 18.6% (95% CI 14.1 to 23.8), of which ampicillin or gentamicin (52.0%) was the most common regimen. Rate of antibiotic prescriptions in general pediatric wards was 46.5%, with third generation cephalosporins being the most used antibiotics. Prescription rate in the oncology ward was 52.9% with antipseudomonal agents or meropenem being the most prescribed antibiotics. Prescription rates in the pediatric intensive care unit (PICU) was 88.9%, with meropenem being the most used antibiotic. Compared to a previous PPS study in 2016, prevalence of antimicrobial use was higher in general pediatric wards at 46.5% versus 37.2% (p=0.02) and PICU at 88.9% versus 67.7% (p=0.007). Conclusion: The prevalence rates of antimicrobial use in pediatric wards increased despite implementation of a prospective audit and feedback antibiotic stewardship program. Other measures are needed to reduce the unnecessary prescriptions. Keywords: Antimicrobial; Antimicrobial stewardship program; Pediatric; Point prevalence survey

scholarly journals Rational Use of Antibiotics – A Point Prevalence Study Carried out at a Tertiary Hospital in South-South Nigeria

2020 ◽  
pp. 39-47
Author(s):  
Okechukwu Chioma
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Point Prevalence ◽  
Prescribing Patterns ◽  
Prevalence Study ◽  
Antibiotic Prescribing ◽  
Point Prevalence Study ◽  
Rational Use ◽  
Rational Use Of Antibiotics

Introduction: The burden of antibiotic resistance in the hospitals and communities is progressively worsening hence the critical need to put into practice all the key components of rational use of antibiotics in our daily patient interactions. This paper aims to highlight the problem of antibiotic resistance, the importance of rational use of antibiotics and to show an on the spot sketch of the antibiotic use pattern among in-patients in the children wards in a tertiary hospital. Methodology: A brief review of the existing literature on antibiotic resistance and the rational use of antibiotics was done. A one-day cross-sectional point prevalence study was conducted in the children wards in UPTH and all children receiving antibiotics on that day, identified. The prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of the survey by the total number of patients on admission. Data were presented in percentages using pie and bar charts. Results: There were a total of 40 children on admission in the paediatric wards with a Male: Female ratio of 1.2:1. 34 (85.0%) of the children on admission were receiving at least one antibiotic. The most common route of administration of the antibiotics was the intravenous route (94.1%). The five most commonly prescribed antibiotics in the children medical wards and the emergency ward were Ceftriaxone, Gentamycin, Cefuroxime, Metronidazole and Crystalline penicillin, while the five most common antibiotics prescribed in the special care baby unit were Gentamycin, Ceftazidime, Ceftriaxone, Metronidazole and Ofloxacin. Only 10 (29.4%) out of children receiving antibiotics had a microbiology culture result available, and 4 were receiving antibiotics in line with the culture sensitivity pattern. Two (5.9%) children had a multidrug-resistant infection. Conclusion: This study showed a high prevalence of antibiotic use among inpatients and low utilization of microbiology culture results in the choice of antibiotics in a tertiary hospital in South-south Nigeria. Antibiotic prescribing patterns among healthcare workers should be improved upon by training and retraining of personnel as well as strict adherence to antibiotic prescription guidelines.

scholarly journals Point prevalence survey of healthcare-associated infections and antimicrobial use in Kosovo hospitals

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Lul Raka ◽  
Gazmend Spahija ◽  
Agreta Gashi-Gecaj ◽  
Astrit Hamza ◽  
Edita Haxhiu ◽  
...  
Keyword(s):  
Prevalence Rate ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Infection Prevention And Control ◽  
Antimicrobial Use ◽  
Surveillance Systems ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Stewardship Program

Health care-associated infections (HAIs) and antimicrobial resistance constitute a major public health challenge. The aim of this study was to assess the prevalence rate of HAIs and antimicrobial use in acute care hospitals in Kosovo. A multicenter study was performed in all hospitals in Kosovo. The standardized protocol for Point Prevalence Survey (PPS) on HAIs and antimicrobial use developed by European Center for Disease Control and Prevention (ECDC) was used for this survey. A total of 915 patients were included in PPS. Countrywide prevalence rate of HAIs was 4.9%. The highest rate was noticed in tertiary care level in University Clinical Centre of Kosovo (UCCK) (7.2%). The most common type of HAI was surgical site infection, representing 35.5% of all reported HAIs. Prevalence of HAIs was highest in surgical departments (46.6%). The median length of stay before onset of HAI was 11 days (range: 3-27 days). Gram negative bacteria were the predominant microorganisms (61% of cases). From all patients, 520 (56.8%) of them were using at least one antibiotic. Ceftriaxone was the most prescribed antibiotic with 40.3%. Antibiotics were administered mainly through parenteral route (93.8%). Empiric treatment was the physician’s choice for prescribing in 87.1%. The main reason for antibiotic treatment was pneumonia (19.8%). Medical prophylaxis was reported in 10% of antibiotic prescriptions. Key recommendations driven by this study are to improve surveillance systems of HAI and antibiotic use, enhance infection prevention and control and establish antimicrobial stewardship program.

scholarly journals Road to Increasing AMR: A Study on Antibiotics Prescribing Pattern

2020 ◽  
Vol 41 (S1) ◽  
pp. s496-s497
Author(s):  
Bobson Derrick Fofanah ◽  
Christiana Conteh ◽  
Jamine Weiss
Keyword(s):  
Broad Spectrum ◽  
Inappropriate Prescribing ◽  
Antibiotic Use ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Antimicrobial Use ◽  
Strict Adherence ◽  
Targeted Interventions ◽  
Broad Spectrum Antibiotics ◽  
Trade Names

Background: Infectious diseases and the rapid emergence of multidrug-resistant pathogens continue to pose a threat to global health. The development of antimicrobial-resistant organisms is an alarming issue caused by inappropriate use of antibiotic agents. It is estimated that death from antimicrobial resistant pathogens could increase >10-fold to ~10 million deaths annually by 2050 if action is not taken. “It is essential to have reliable data on how medicines are used in order to identify areas to develop targeted interventions” (WHO 2011). Investigating antimicrobial use in hospitals is the first step in evaluating the underlying causes of AMR. In Sierra Leone, no other study related to antibiotic prescribing patterns in hospital setting has been undertaken. Objective: To investigate antibiotic prescription patterns using the WHO hospital antimicrobial use indicator tool at the Kingharman Hospital for 1 month. Methods: Data were collected from patient charts for 1 month, January 1–31, 2019. A data extraction tool was used to capture information on patient demographics, diagnosis, and antibiotics prescription details regarding dosage, duration, and frequency of administration. The tool adopted 6 selected indicators from the WHO antimicrobial use manual to measure the extent of antibiotic use in hospital and performance among prescribers. Results: Of the 189 charts reviewed, 175 included antibiotic prescriptions. The percentage of prescriptions involving antibiotics was 92.5%. The average number of drugs prescribed was 2, with an average duration of 5.2 days. Moreover, 50.5% of antibiotics prescribed were generic, and 96.6% were from the Ministry of Health and Sanitation Essential Medicine List (EML). The most commonly used antibiotics were ciprofloxacin (38.8%), followed by ceftriaxone (23.0%), amoxicillin (16.8%), metronidazole (8.5%), and others(12.7%). Typhoid accounted for 34.8% of broad-spectrum antibiotics, UTI accounted for 17.7%, malaria accounted for 12.5%, 25.5% were unspecified, and 9.5% were for unclear diagnoses. Typically, combinations of fluroquinolones and cephalosporins were used to treat typhoid and UTIs. Conclusions: This cross-sectional study represents a broad picture of antibiotic prescribing patterns at the King Harman Hospital. There was no strict adherence to the WHO recommended prescribing guidelines. These findings also indicate the degree of irrational and inappropriate prescribing of broad-spectrum antibiotics. This study highlights the need for a comprehensive assessment of antimicrobial use to gain a better understanding of national antibiotic use and to guide interventions to reducing AMR.Funding: NoneDisclosures: NoneIf I am discussing specific healthcare products or services, I will use generic names to extent possible. If I need to use trade names, I will use trade names from several companies when available, and not just trade names from any single company.DisagreeChristiana Kallon

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