Analysis of hospital antimicrobial consumption to identify targets for antimicrobial stewardship

Yusef, Dawood; Hayajneh, Wail A.; Bond, Stuart; Lee-Milner, Jade; Al‐Azzam, Sayer; Issa, Ali Bani; Jaradat, Sara K.; Gould, Ian M.; Conway, Barbara R.; Hasan, Syed Shahzad; Aldeyab, Mamoon A.

doi:10.1017/ice.2021.126

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…The WHO supported the establishment of antimicrobial consumption surveillance systems [7]. This is essential for evaluating amounts, patterns, and trends in antimicrobial use, performing benchmarking and risk adjustment, providing essential data for setting and implementing targets to improve antibiotic use and resistance, linking antibiotic use with resistance, and raising awareness among healthcare professionals, policy-makers, and the public about the need to address inappropriate use of antimicrobials, as well as its contribution to the development of AMR [7][8][9][10]. Measuring antimicrobial use is important for informing antimicrobial stewardship activities [10,11].…”

Section: Introductionmentioning

confidence: 99%

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

et al. 2021

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Coronavirus disease 2019 (COVID-19) has overlapping clinical characteristics with bacterial respiratory tract infection, leading to the prescription of potentially unnecessary antibiotics. This study aimed at measuring changes and patterns of national antimicrobial use for one year preceding and one year during the COVID-19 pandemic. Annual national antimicrobial consumption for 2019 and 2020 was obtained from the Jordan Food and Drug Administration (JFDA) following the WHO surveillance methods. The WHO Access, Watch, and Reserve (AWaRe) classification was used. Total antibiotic consumption in 2020 (26.8 DDD per 1000 inhabitants per day) decreased by 5.5% compared to 2019 (28.4 DDD per 1000 inhabitants per day). There was an increase in the use of several antibiotics during 2020 compared with 2019 (third generation cephalosporins (19%), carbapenems (52%), macrolides (57%), and lincosamides (106%)). In 2020, there was a marked reduction in amoxicillin use (−53%), while the use of azithromycin increased by 74%. National antimicrobial consumption of the Access group decreased by 18% from 2019 to 2020 (59.1% vs. 48.1% of total consumption). The use of the Watch group increased in 2020 by 26%. The study highlighted an increase in the use of certain antibiotics during the pandemic period that are known to be associated with increasing resistance. Efforts to enhance national antimicrobial stewardship are needed to ensure rational use of antimicrobials.

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Section: Introductionmentioning

confidence: 99%

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

et al. 2021

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“…This serves as a proper window into the uptake and application of ASP in both countries, particularly Jordan. While most published literature alludes to the significant success of ASP strategies in the UAE and Jordan, 41,42 our findings must be dissected by health policy makers to better understand the deep-rooted limitations and strategies to alleviate them. In the context of university education, for example, revolutionization of health education curricula and targeted awareness campaigns to students tackling ASP and antimicrobial resistance are urgently needed.…”

Section: Discussionmentioning

confidence: 97%

A Comparative Piloting of Determinants of Self-Medication Among University Students in the MENA Region; UAE and Jordan as an Example

Al-Zoubi¹,

Nasor²,

Suliman³

et al. 2023

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Purpose Unsupervised self-medication (SM) is a global public health concern. University students are particularly vulnerable due to misperceptions of improved academic performance and thus are at risk of dependence, addiction, and drug overdose. Past studies have shown an alarming prevalence of SM among university students in the Middle East and North Africa (MENA) region. However, there is a scarcity of reports from the region dissecting determinants of SM. Therefore, this study aimed to determine the prevalence and epidemiological correlates of SM among university students and its perceived impact on their academic performance. Methods Two countries in the MENA region were surveyed in a cross-sectional design; UAE and Jordan. Through a stratified sampling technique, undergraduate students in both healthcare and non-healthcare majors of study were recruited to participate. A structured, self-administered questionnaire developed for the purpose of this study was distributed to consented participants via the university’s official email. Statistical analyses were performed using SPSS. Descriptive and inferential statistics were used to analyze data. A p -value <0.05 was considered statistically significant. Results A total of 362 students participated in the study (74% were females, 60% were from the UAE, and 59% were in healthcare majors). Significantly higher prevalence rates and adjusted odds of SM were found among females, students from Jordan, and those in healthcare majors, particularly for paracetamol (90.2% of females [ p =0.001], 88.3% from Jordan [ p =0.03], 92.5% in healthcare majors [ p =0.001]) and antibacterial drugs (48.9% of females [ p =0.01], 60.7% from Jordan [ p =0.001], 53.3% in healthcare majors [ p =0.001]). Majoring in healthcare fields was the most consistent determinant of such practice, while social influences of family and friends represented the chief source of recommendation. Only 21% of respondents assumed SM boosts their academic performance. Conclusion Our pilot study underlines the predominant determinants of SM among university students in the MENA region, namely female gender, students from Jordan, and those in healthcare majors. Informed data-driven awareness campaigns to mitigate such practice should be designed to focus on these susceptible populations.

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“…Antibiotic usage quantities were obtained on a monthly basis from the hospital pharmacy information systems (JAC). These data were then converted into Defined Daily Doses (DDD), in line with the classification of antimicrobials for systemic use (J01) in the WHO/ATC index and expressed as DDD per 1000 occupied bed-days (OBD) [ 39 , 40 ].…”

Section: Methodsmentioning

confidence: 99%

A Threshold Logistic Modelling Approach for Identifying Thresholds between Antibiotic Use and Methicillin-Resistant Staphylococcus aureus Incidence Rates in Hospitals

et al. 2022

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The aim of this study was to demonstrate the utility of threshold logistic modelling, an innovative approach in identifying thresholds and risk scores in the context of population antibiotic use associated with methicillin-resistant Staphylococcus aureus (MRSA) incidence rates in hospitals. The study also aimed to assess the impact of exceeding those thresholds that resulted in increased MRSA rates. The study was undertaken in a 700-bed hospital in England between January 2015 and December 2021 (84 monthly observations). By employing the threshold logistic modelling approach, we: (i) determined the cut-off percentile value of MRSA incidence that defines a critical level of MRSA; (ii) identified thresholds for fluoroquinolone and co-amoxiclav use that would accelerate MRSA incidence rates and increase the probability of reaching critical incidence levels; (iii) enabled a better understanding of the effect of antibiotic use on the probability of reaching a critical level of resistant pathogen incidence; (iv) developed a near real-time performance monitoring feedback system; (v) provided risk scores and alert signals for antibiotic use, with the ability to inform hospital policies, and control MRSA incidence; and (vi) provided recommendations and an example for the management of pathogen incidence in hospitals. Threshold logistic models can help hospitals determine quantitative targets for antibiotic usage and can also inform effective antimicrobial stewardship to control resistance in hospitals. Studies should work toward implementing and evaluating the proposed approach prospectively, with the aim of determining the best counter-measures to mitigate the risk of increased resistant pathogen incidence in hospitals.

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Analysis of hospital antimicrobial consumption to identify targets for antimicrobial stewardship

Cited by 4 publications

References 7 publications

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

A Comparative Piloting of Determinants of Self-Medication Among University Students in the MENA Region; UAE and Jordan as an Example

A Threshold Logistic Modelling Approach for Identifying Thresholds between Antibiotic Use and Methicillin-Resistant Staphylococcus aureus Incidence Rates in Hospitals

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