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

Abstract

(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.

Transmission of Antimicrobial Resistant Bacteria at the Hajj: A Scoping Review

“…Twenty-six of the 51 papers reported the results of AMR-related research conducted in hospital settings [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ] while eight were case reports [ 31 , 38 , 40 , 41 , 53 , 54 , 55 , 56 ]. One was an outbreak report [ 21 ], one hospital-based case-control study [ 45 ], and one article was an environmental to detect AMR in Makkah [ 57 ].…”

“…Among the respiratory disease-causing AMR bacteria: Staphylococcus spp. in 17 studies [ 28 , 30 , 33 , 36 , 37 , 42 , 43 , 48 , 52 , 55 , 57 , 61 , 63 , 64 , 67 , 68 , 69 ], Streptococcus spp. in seven study [ 33 , 42 , 65 , 70 , 71 , 72 , 73 ], Neisseria meningitidis in three studies [ 21 , 22 , 54 ], Haemophilus influenzae was reported in two studies [ 27 , 32 ], Mycobacterium tuberculosis in two studies [ 74 , 75 ], and Stenotrophomonas maltophilia in one study [ 38 ].…”

Overuse of antibiotics in Saudi children with upper respiratory infection and diarrhea

“…Antimicrobials were administered parenterally to the vast majority of patients (90.3%). About 53.7% of the total antimicrobials prescriptions were utilized in medical departments, 23.7% in surgical departments, and 22.6% in intensive care units (Haseeb et al, 2021).…”

Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review

“…Although highly recommended by the healthcare community, prophylactic drugs are included in the crucial immunosuppressive regimen, resulting in considerable economic burden for the immunocompromised patients [ 38 ]. Routine PCP prophylaxis is recommended for patients treated in hospitals where the prevalence of PCP is at least 3% to 5% among immunocompromised patients [ 12 , 39 , 40 ]. Moreover, the risk of PCP among transplant recipients is greater in 1–6 month post-transplantation period, during prolonged neutropenia, or in patients receiving steroids, antilymphocyte antibodies, or calcineurin inhibitors [ 41 ].…”