Evaluation of antibiotic prescribing for adult inpatients at Sultan Qaboos University Hospital, Sultanate of Oman

Abstract

ObjectiveLittle is known into the prudent use of antibiotics in hospitals in Oman. This study is to evaluate antibiotic prescribing by measuring the overall compliance with the local antibiotic prescribing guidelines.MethodsAn observational study involving 366 patients’ admission episodes as determined by power analysis on patients (≥18 years) on oral and/or parenteral antibiotic during admission, in the period of 10 weeks (1 February–15 April, 2014). The adapted audit tool of the Barking, Havering and Redbridge University Hospitals NHS Trust was used for this study. Analyses were performed using descriptive statistics. Main outcome measures: antibiotic prescribing compliance with the local guidelines as well as the overall restricted antibiotic policy adherence at Sultan Qaboos University Hospital (SQUH).ResultsThe number of prescribed and audited antibiotics totalled 825, compliance with local guidelines was suboptimal at 63% (n=520), and of 211 restricted antibiotics prescribed, the overall adherence to restricted antibiotic policy was inadequate at 46% (n=98). The majority of the antibiotics prescribed were broad spectrum at 90% (n=739), mainly penicillins at 31% (n=256) and cephalosporins at 17% (n=139).ConclusionThe study has provided valuable baseline details of antibiotic prescribing patterns in SQUH. The diagnosis was documented in 89% (n=327) of the admission episodes. However, the compliance with SQUH antibiotic prescribing guidelines was suboptimal, and the overall compliance with SQUH restricted antibiotic guidelines was in 46% of the prescriptions. Further studies are required to address the reasons behind the non-compliance with local guidelines.

Clinical and Cost Implications of Clinical Pharmacist Interventions on Antimicrobial Use at Sultan Qaboos University Hospital in Oman

“…The three most common antimicrobials requiring modifications in our study were meropenem, piperacillin/tazobactam and vancomycin. This largely reflects the prescribing pattern of antibiotics as SQUH as shown by Al Maliky et al (Al-Maliky et al, 2018) where the highest number of prescriptions were made for piperacillin/tazobactam (22%), followed by azithromycin (15%) and then meropenem (11% of total antimicrobial prescriptions). Interventions on meropenem were mainly in the ICU (>90%).…”

“…There are several proposed explanations for this high rate. Firstly, it is known that the ICU represents the heaviest antibiotic burden within the hospital (Brusselaers et al, 2011) and studies have shown that up to 60% of antibiotics prescribed in ICUs are inappropriate, which is higher than other disciplines of care (Luyt et al, 2014;Al-Maliky et al, 2018). Additionally, AMS services are provided on a small scale in the ICU with weekly meetings between an ICU team doctor, and infectious diseases (ID) consultant and a CP.…”

Hospital adoption of antimicrobial stewardship programmes in Gulf Cooperation Council countries: A review of existing evidence

“…Two studies from Bahrain reported increased use of broad spectrum antibiotics like ceftriaxone due to resistance to first and second line options [31,32]. One Omani study reported that 90% of antibiotic prescriptions were for broad spectrum antibiotics due to lack of adherence with antimicrobial guidelines and policies [40]. An oral presentation in 2013 also reports a decline in using broad-spectrum antibiotics in an UAE hospital as a result of antimicrobial stewardship interventions in that setting [59].…”

Evaluation of inappropriate antibiotic prescribing and management through pharmacist-led antimicrobial stewardship programmes: a meta-analysis of evidence

“…Articles excluded were 57 reviews, 78 articles without prescribing patterns, 53 that came from outside the Gulf region, and 128 articles with outcomes other than inappropriateness; the remaining 18 articles were included. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In the second step, a total of 2453 articles were searched, and after removing duplications 2357 were from PubMed, two from Embase and one from Elsevier. Nine hundred and one articles were excluded based on the abstract, and 1349 based on the title; 110 articles were included and studied thoroughly.…”