Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals

(1) Background: Inappropriate use of antimicrobials and subsequently rise of antimicrobial resistance (AMR) remains a major public health priority. Over-prescribing of broad-spectrum antibiotics is one of the main contributing factors for the emergence of AMR. We sought to describe antimicrobial prescribing trends among patients in public hospitals in Makkah hospitals. (2) Method: We undertook a point prevalence survey (PPS) in six hospitals in Makkah, Saudi Arabia, from January 2019 to July 2019. The survey included all the inpatients receiving antimicrobials on the day of PPS. Data was collected using the Global point prevalence survey (PPS) tool developed by the University of Antwerp, Belgium. (3) Results: Of 710 hospitalized patients, 447 patients (61.9%) were treated with one or more antimicrobials during the study period. The average bed occupancy among six hospitals was 74.4%. The majority of patients received antimicrobials parenterally (90.3%). Of the total prescribed antimicrobials, 415 (53.7%) antimicrobials were used in medical departments, 183 (23.7%) in surgical departments, and 175 (22.6%) in ICUs. Pneumonia (17.3%), skin and soft tissue infections (10.9%), and sepsis (6.6.%) were three common clinical indications. Ceftriaxones were the most commonly used antibiotics that were prescribed in 116 (15%) of patients, followed by piperacillin, with an enzyme inhibitor in 84 (10.9%). (4) Conclusion: There was a high prevalence of antibiotic use in the hospitals of Makkah, which could be a potential risk factor for the incidence of resistant strains, particularly MRSA infection. Public health decision-makers should take these findings into consideration to update national policies for antibiotic use in order to reduce the risks of further increases of AMR.

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

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v19i2.23 ◽

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

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Correlation Between Tennessee Antibiotic Use Point Prevalence Survey and NHSN AUR Module in Four Acute Care Hospitals

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1326 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S511-S511

Author(s):

Christopher Evans ◽

Raphaelle Beard ◽

Zina Gugkaeva ◽

Brooke Stayer ◽

Candice Simpson ◽

...

Keyword(s):

Acute Care ◽

Acute Care Hospitals ◽

Antibiotic Use ◽

Point Prevalence ◽

Prevalence Survey ◽

Point Prevalence Survey

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Variations in antibiotic use across India: multi-centre study through Global Point Prevalence survey

Journal of Hospital Infection ◽

10.1016/j.jhin.2019.05.014 ◽

2019 ◽

Vol 103 (3) ◽

pp. 280-283 ◽

Cited By ~ 6

Author(s):

S.K. Singh ◽

S. Sengupta ◽

R. Antony ◽

S. Bhattacharya ◽

C. Mukhopadhyay ◽

...

Keyword(s):

Antibiotic Use ◽

Point Prevalence ◽

Prevalence Survey ◽

Multi Centre Study ◽

Centre Study ◽

Point Prevalence Survey

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Prevalence of device use and transmission based precautions in nineteen large Australian acute care public hospitals: Secondary outcomes from a national healthcare associated infection point prevalence survey

Infection Disease & Health ◽

10.1016/j.idh.2020.05.006 ◽

2020 ◽

Vol 25 (4) ◽

pp. 262-267

Author(s):

Philip L. Russo ◽

Andrew J. Stewardson ◽

Allen C. Cheng ◽

Tracey Bucknall ◽

Brett G. Mitchell

Keyword(s):

Acute Care ◽

Public Hospitals ◽

Point Prevalence ◽

Healthcare Associated Infection ◽

Prevalence Survey ◽

National Healthcare ◽

Point Prevalence Survey ◽

Secondary Outcomes ◽

Device Use ◽

Healthcare Associated

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A Point Prevalence Survey of Antibiotic Use in 18 Hospitals in Egypt

Antibiotics ◽

10.3390/antibiotics3030450 ◽

2014 ◽

Vol 3 (3) ◽

pp. 450-460 ◽

Cited By ~ 17

Author(s):

Maha Talaat ◽

Tamer Saied ◽

Amr Kandeel ◽

Gehad El-Ata ◽

Amani El-Kholy ◽

...

Keyword(s):

Antibiotic Use ◽

Point Prevalence ◽

Prevalence Survey ◽

Point Prevalence Survey

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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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1698 ◽

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.

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

BMJ Open ◽

10.1136/bmjopen-2020-042819 ◽

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.

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