scholarly journals Antimicrobial Use at Acute Care Hospitals in Nova Scotia: A Point Prevalence Survey

2018 ◽  
Vol 71 (4) ◽  
Author(s):  
Emily Black ◽  
Heather Neville ◽  
Mia Losier ◽  
Megan Harrison ◽  
Kim Abbass ◽  
...  
Keyword(s):  
Nova Scotia ◽  
Antimicrobial Agent ◽  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Agents ◽  
Treatment Guidelines ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Prevalence Survey ◽  
Point Prevalence Survey

<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Point prevalence surveys are used to monitor antimicrobial use and identify targets for improvement through antimicrobial stewardship activities. Few studies have evaluated antimicrobial use in Nova Scotia acute care institutions.</p><p><strong>Objectives: </strong>To determine the prevalence and characteristics of antimicrobial use in Nova Scotia hospitals.</p><p><strong>Methods:</strong> A point prevalence survey was conducted between June and November 2015 for patients admitted to hospitals with at least 30 acute care beds. On each survey day, charts were reviewed to identify patients receiving antimicrobial agents on that day. Data were gathered on the type of antimicrobial agent prescribed, route of administration, intended duration of use, and indication. Adherence to regional and local treatment guidelines was assessed. Results were summarized descriptively. Findings were compared using the Fisher exact test or the Cochran–Armitage trend test.</p><p><strong>Results:</strong> Twelve of the 13 eligible hospitals participated, and a total of 1499 patient charts were examined. The overall prevalence of antimicrobial use was 30.6% (458/1499). The prevalence of antimicrobial use differed<br />significantly according to area of specialty, with the highest prevalence occurring in intensive care wards (47.2%, 50/106) and surgical wards (43.4%, 179/412), as compared with medical wards (27.9%, 192/687) and “other” specialty wards (11.1%, 32/289) (p &lt; 0.001). Among the 520 indications for antimicrobial use, the most common was respiratory tract infection (81 or 15.6%). In total, 660 antimicrobial agents were prescribed to the 458 patients; a third of these patients (152 or 33.2%) received more than 1 antimicrobial agent. The class of antimicrobials most frequently prescribed was “other beta-lactam antimicrobials” (31.2%, 206/660). The majority of antimicrobials (62.0%, 409/660) were prescribed for administration via the parenteral route. Adherence to regional treatment guidelines was 29.9% (26 of 87 indications analyzed). Documentation of indication was lacking for 104 (20.0%) of the 520 indications, and documentation of the intended duration of antimicrobial use was lacking for 326 (62.7%) of the 520 indications.</p><p><strong>Conclusions:</strong> Antimicrobial agents were prescribed for about one-third of acute care patients in Nova Scotia. Specific targets for improvement in antimicrobial use include decreases in prescribing of broad-spectrum and parenteral antimicrobials, better adherence to guidelines, and improved documentation. In developing initiatives, antimicrobial stewardship programs in Nova Scotia should focus on identified targets for improvement.</p><p><strong>RÉSUMÉ</strong></p><p>Contexte: Les enquêtes de prévalence ponctuelle sont employées pour surveiller l’utilisation des antimicrobiens et cibler des points à améliorer grâce aux activités de gestion responsable des antimicrobiens. Peu d’études se sont penchées sur l’utilisation des antimicrobiens dans les établissements de soins de courte durée en Nouvelle-Écosse.</p><p><strong>Objectifs :</strong> Déterminer quelle est la prévalence de l’utilisation des anti -microbiens dans les hôpitaux de la Nouvelle-Écosse et offrir un portrait de cette utilisation.</p><p><strong>Méthodes :</strong> Une enquête de prévalence ponctuelle a été menée entre juin et novembre 2015 pour les patients admis aux hôpitaux dotés d’au moins 30 lits de soins de courte durée. À chaque jour d’enquête, des dossiers médicaux ont été examinés afin de repérer les patients ayant reçu des agents antimicrobiens cette journée-là. On a recueilli des données sur le type d’agent antimicrobien prescrit, la voie d’administration, la durée attendue d’utilisation et l’indication. Le respect des lignes directrices thérapeutiques régionales et locales a aussi été évalué. Les résultats ont été résumés de façon descriptive. Les comparaisons ont été vérifiées à l’aide du test exact de Fisher ou du test de tendance de Cochran-Armitage.</p><p><strong>Résultats :</strong> Douze des 13 hôpitaux admissibles ont été inclus et un total de 1 499 dossiers médicaux de patients ont été examinés. Le taux de prévalence globale d’utilisation d’antimicrobiens était de 30,6 % (458/1499).<br />La prévalence d’utilisation d’antimicrobiens variait significativement selon les unités de soins : en tête de liste, les unités de soins intensifs (47,2 %, 50/106) et les unités de chirurgie (43,4 %, 179/412) comparativement aux unités de médecine (27,9 %, 192/687) et aux « autres » unités de soins (11,1 %, 32/289) (p &lt; 0.001). Parmi les 520 indications pour l’utilisation des antimicrobiens, la plus fréquente était l’infection des voies respiratoires (81 ou 15,6 %). Au total, 660 agents antimicrobiens ont été prescrits aux 458 patients et le tiers de ces patients (152 ou 33,2 %) ont reçu plus d’un agent antimicrobien. La classe d’antimicrobien la plus souvent prescrite était les « autres bêtalactamines » (31,2 %, 206/660). La voie parentérale était prescrite pour l’administration de la majorité desantimicrobiens (62,0%, 409/660). Le respect des lignes directrices régionales de traitement était de 29,9 % (26 des 87 indications analysées). Parmi les 520 indications, 104 (20,0 %) n’étaient pas mentionnées au dossier et 326 (62,7 %) étaient dépourvues de mention de la durée du traitement antimicrobien au dossier.</p><p><strong>Conclusions :</strong> Des agents antimicrobiens ont été prescrits à environ un tiers des patients recevant des soins de courte durée en Nouvelle-Écosse. L’amélioration de l’utilisation des antimicrobiens devrait cibler précisément les réductions de la prescription d’antibiotiques à large spectre et du recours à la voie parentérale, un plus grand respect des lignes directrices et une meilleure consignation. Les programmes de gestion responsable des antimicrobiens en Nouvelle-Écosse devraient être axés sur des objectifs d’amélioration définis afin de mettre au point des stratégies.</p>

scholarly journals Antimicrobial use in European acute care hospitals: results from the second point prevalence survey (PPS) of healthcare-associated infections and antimicrobial use, 2016 to 2017

2018 ◽  
Vol 23 (46) ◽  
Author(s):  
Diamantis Plachouras ◽  
Tommi Kärki ◽  
Sonja Hansen ◽  
Susan Hopkins ◽  
Outi Lyytikäinen ◽  
...  
Keyword(s):  
Acute Care ◽  
Antimicrobial Agents ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Surgical Prophylaxis ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Healthcare Associated

Antimicrobial agents used to treat infections are life-saving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016–17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2–31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials.

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 Antimicrobial use in acute care hospitals: national point prevalence survey on healthcare-associated infections and antimicrobial use, Switzerland, 2017

2019 ◽  
Vol 24 (33) ◽  
Author(s):  
Walter Zingg ◽  
Aliki Metsini ◽  
Céline Gardiol ◽  
Carlo Balmelli ◽  
Michael Behnke ◽  
...  
Keyword(s):  
Acute Care ◽  
Broad Spectrum ◽  
Acute Care Hospitals ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Broad Spectrum Antibiotics ◽  
Healthcare Associated

Background A point prevalence survey (PPS) on healthcare-associated infections (HAI) and antimicrobial use was conducted in Swiss acute care hospitals in 2017. Aim Our objective was to assess antimicrobial use in Swiss acute care hospitals. Methods All patients hospitalised in any acute care hospital in Switzerland were eligible. We used the most recent version of the PPS protocol of the European Centre for Disease Prevention and Control. Results Data from 12,931 patients of 96 hospitals were collected. Of these, 4,265 (33%; 95% confidence interval (CI): 32.2–33.8) were on 5,354 antimicrobials for 4,487 indications. Most of the 2,808 therapeutic indications addressed 1,886 community-acquired infections (67.2%; 95% CI: 65.4–68.9). Of the 1,176 surgical prophylaxes, 350 (29.8%; 95% CI: 27.1–32.4) exceeded the duration of 1 day. Of the 1,090 antimicrobial regimens that were changed, 309 (28.3%; 95% CI: 25.7–31.0) were escalated and 337 (30.9%; 95% CI: 28.2–33.7) were de-escalated. Amoxicillin/clavulanic acid was the most frequent antimicrobial (18.8%; 95% CI: 17.7–19.8), prescribed mainly for therapeutic indications (76.0%; 95% CI: 73.3–78.7). A total of 1,931 (37.4%; 95% CI: 36.1–38.8) of the 5,158 antimicrobials for systemic use were broad-spectrum antibiotics, most frequently third- and fourth-generation cephalosporins (35.9%; 95% CI: 33.8–38.1). Conclusions Antimicrobial consumption was at European average, the use of broad-spectrum antibiotics in the lower third. Swiss acute care hospitals should invest in antimicrobial stewardship, particularly in reducing the use of broad-spectrum antibiotics.

scholarly journals Point Prevalence Survey of Benzodiazepine and Sedative-Hypnotic Drug Use in Hospitalized Adult Patients

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Heather L Neville ◽  
Mia Losier ◽  
Jennifer Pitman ◽  
Melissa Gehrig ◽  
Jennifer E Isenor ◽  
...  
Keyword(s):  
Nova Scotia ◽  
Acute Care ◽  
Addiction Treatment ◽  
Age Groups ◽  
Point Prevalence ◽  
Adult Patients ◽  
Prevalence Survey ◽  
Term Care ◽  
Soins Intensifs ◽  
Point Prevalence Survey

 ABSTRACTBackground: Benzodiazepines and sedative-hypnotic drugs (BZD/ SHDs), such as zopiclone and the antidepressant trazodone, pose risks such as falls, fractures, and confusion, especially for older adults. Use of these drugs in the acute care setting is poorly understood.Objectives: To determine the point prevalence and characteristics of use of BZD/SHDs in hospitals in Nova Scotia, Canada.Methods: A point prevalence survey was conducted for adults admitted to all hospitals with at least 30 acute care beds between May and August 2016. Drugs administered intravenously, patients in long-term care, and patients receiving mental health services, addiction treatment, or critical care were excluded. The proportion of included patients who had received a BZD/SHD within the 24 h before the start of the survey was determined. A descriptive statistical analysis was performed.Results: Overall BZD/SHD prevalence was 34.6% (487/1409) across the 16 eligible hospitals. The average age was 70.3 years, and 150 (30.8%) of the patients were 80 years or older. Among the 585 prescriptions for these patients, commonly used drugs were zopiclone (32.0%), lorazepam (21.9%), and trazodone (21.9%). The most common indications for use were bedtime/daytime sedation (60.0%) and anxiety (12.5%). More than half of the prescriptions (55.7%) had been initiated at home, 37.6% were started in hospital, and the place of initiation was unknown for 6.7%. Benzodiazepines were prescribed more frequently to patients under 65 years than those 80 years or older (41.3% versus 22.2%, p < 0.001) whereas trazodone was more frequently prescribed to the older of these 2 age groups (52.7% versus 14.3%, p < 0.001).Conclusions: BZD/SHDs were frequently used by hospitalized adult patients in Nova Scotia. Trazodone appears to have been substituted for benzodiazepines in the oldest age group. Pharmacists should direct their efforts toward preventing inappropriate initiation of BZD/SHDs in hospital, particularly for elderly patients.RÉSUMÉContexte : Les benzodiazépines et les médicaments sédatifs-hypnotiques (BZD/MSH), comme la zopiclone et l’antidépresseur trazodone, comportent des risques de chute, de fracture et de confusion, particulièrement chez les personnes âgées. Il existe une mauvaise compréhension de l’utilisation de ces médicaments dans un contexte de soins intensifs.Objectifs : Déterminer la prévalence ponctuelle et les caractéristiques de l’utilisation des BZD/MSH dans des hôpitaux en Nouvelle-Écosse, au Canada.Méthodes : Une enquête sur la prévalence ponctuelle a été menée entre mai et août 2016 auprès d’adultes admis dans les hôpitaux comptant au moins 30 lits en soins intensifs. Les patients recevant ces medicaments par voie intraveineuse, ceux en établissement de soins de longue durée, ceux recevant des services en santé mentale ou un traitement pour la toxicomanie ou encore ceux des soins intensifs ont été exclus de l’enquête. La détermination de la proportion des patients inclus dans l’étude portait sur ceux qui avaient reçu des BZD/MSH au cours des 24 h précédant le début de l’enquête, et elle a été suivie d’une analyse statistique descriptive.Résultats :De manière générale, l’usage des BZD/MSH s’élevait à 34,6 % (487/1409) dans les 16 hôpitaux participants. L’âge moyen des patients était de 70,3 ans et 150 (30,8 %) étaient âgés d’au moins 80 ans. Parmi les 585 prescriptions pour ces patients, les médicaments communément utilisés étaient la zopiclone (32,0 %), le lorazepam (21,9 %) et le trazodone (21,9 %). Les indications d’utilisation les plus répandues concernaient la sédation au coucher et en cours de journée (60 %) et l’anxiété (12,5 %). Plus de la moitié des prescriptions (55,7 %) ont commencé à domicile, 37,6 % ont commencé à l’hôpital, et le lieu du début de la prise de ces médicaments était inconnu dans 6,7 % des cas. La prescription des benzodiazépines s’adressait plus souvent aux patients de moins de 65 ans qu’à ceux d’au moins 80 ans (41,3 % par rapport à 22,2 %, p < 0,001), tandis que la prescription de trazodone s’adressait plus souvent aux personnes de la tranche d’âge plus avancée (52,7 % par rapport à 14,3 %, p < 0,001).Conclusions : Les BZD/MSH étaient fréquemment utilisés par les patients adultes hospitalisés en Nouvelle-Écosse. La trazodone semble avoir remplacé les benzodiazépines dans le groupe plus âgé. Les pharmaciens devraient orienter leurs efforts sur la prévention de la prise inappropriée des BZD/MSH en hôpital, particulièrement par les patients plus âgés.

scholarly journals Point prevalence survey of antimicrobial utilization in oncology patients

2013 ◽  
Vol 7 (12) ◽  
pp. 990-993 ◽  
Author(s):  
Arwa Hammuda ◽  
Sara Hayder ◽  
Shereen Elazzazy ◽  
Emily Black
Keyword(s):  
Antimicrobial Agents ◽  
Primary Objective ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Beta Lactamase ◽  
Antimicrobial Consumption ◽  
Prevalence Survey ◽  
Point Prevalence Survey ◽  
Antimicrobial Utilization ◽  
Lactamase Inhibitor

Introduction: Point prevalence surveys have been used internationally to characterize the use of antimicrobial agents. The primary objective of this study was to determine prevalence of antimicrobial use in the oncology population in Qatar. Methodology: Data was collected from the National Center for Cancer Care and Research hospital over 3 separate days during a two week period. Adults admitted on the day of audit were included. Results: Prevalence of antimicrobial use during the audit was 43% (25/58). The most commonly prescribed class of antimicrobial agents was penicillin/Beta-lactamase inhibitor combinations 39.4% (13/33). Conclusions: Findings demonstrate frequent antimicrobial consumption of broad spectrum antimicrobial agents which highlights the importance of expanding antimicrobial stewardship programs in this population.

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