Point prevalence survey of antimicrobial use and healthcare-associated infections in Belgian acute care hospitals: results of the Global-PPS and ECDC-PPS 2017

Vandael, Eline; Latour, Katrien; Goossens, Herman; Magerman, Koen; Drapier, Nico; Catry, Boudewijn; Versporten, Ann

doi:10.1186/s13756-019-0663-7

Cited by 47 publications

(49 citation statements)

References 10 publications

(17 reference statements)

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“… 8 , 15 Other studies have shown a prevalence of 51.4%, 57.1% and 55.6% for antimicrobial use in three different hospitals in Ghana. 7 , 16 Findings from our study are similar to antibiotic use data reported from many African institutions, 17 , 18 but higher compared with reports in many reviews spanning several other regions. 19 , 20 We realized that the context in which antibiotics are prescribed in sub-Saharan Africa is similar and there is a consensus that antibiotic use in the sub-region is high.…”

Section: Discussionsupporting

confidence: 86%

Antimicrobial use in hospitalized patients: a multicentre point prevalence survey across seven hospitals in Ghana

Obeng‐Nkrumah

Dayie

Egyir

et al. 2021

JAC-Antimicrobial Resistance

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Background Antimicrobial resistance (AMR) is a public health crisis of global proportions. Data is required to understand the local drivers of antimicrobial resistance and support decision-making processes including implementation of appropriate antimicrobial stewardship strategies. Objectives To measure antimicrobial usage in hospitals in Ghana. Methods Using the Global Point Prevalence instruments and processes, we conducted point prevalence surveys across AMR surveillance sentinel hospitals in Ghana, between September and December 2019. Hospital records of all inpatients on admission at 0800 hours on a specific day were reviewed for antimicrobial use at the time of the survey. Data on antibiotic use, including indication for use and quality of prescribing were recorded. Results Overall prevalence of antibiotic use across the sentinel sites was 54.9% (n = 1591/2897), ranging between 48.4% (n = 266/550) and 67.2% (n = 82/122). The highest prevalence of antibiotic use 89.3% (n = 25/28) was observed in adult ICUs. The average number of antibiotics prescribed per patient was 1.7 (n = 1562/2620), with the majority (66%, n = 728/2620) administered via the parenteral route. The five most-commonly used antibiotics were metronidazole (20.6%, n = 541/2620), cefuroxime (12.9%, n = 338/2620), ceftriaxone (11.8%, n = 310/2620), amoxicillin/clavulanic acid (8.8%, n = 231/2620) and ciprofloxacin (7.8%, n = 204/2620). The majority (52.2%; n = 1367/2620) of antibiotics were prescribed to treat an infection, whilst surgical prophylaxis accounted for 26.1% (n = 684/2620). Conclusions We observed a high use of antibiotics including metronidazole and cephalosporins at the participating hospitals. Most antibiotics were empirically prescribed, with low use of microbiological cultures. High usage of third-generation cephalosporins especially for community-acquired infections offers an opportunity for antibiotic stewardship interventions.

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Section: Discussionsupporting

confidence: 86%

Antimicrobial use in hospitalized patients: a multicentre point prevalence survey across seven hospitals in Ghana

Obeng‐Nkrumah

Dayie

Egyir

et al. 2021

JAC-Antimicrobial Resistance

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“…High adherence of prescriptions to the standard treatment guidelines in the current study (84.0%) is similar to previous studies in South Africa (98.0%), Northern Ireland (72.0%-81.8%), Jordan (92.2%-92.7%), Brazil (76.5%-87.3%) and Belgium (76.6%). [23][24][25][26] In contrast to these findings, a study in Nigeria found low adherence, ranging from 0.3% to 7.2%. 22 The finding of high adherence in Mbeya ZRH (94.0%), in contrast to the 63.0% found in 2018 by another study in the same hospital, may be accounted for by the possibility of postsurvey sensitisation and/or awareness.…”

Section: Open Accessmentioning

confidence: 76%

“…In contrast to our findings, appreciable numbers of patients were managed based on laboratory Open access results in South Africa, Brazil and Belgium. [24][25][26] Therefore, to avert the empirical use of antibiotics in these referral hospitals, it is recommended that similar PSS be routinely conducted to assess the trend. Also, addressing hospital-based and/or individual-based factors hindering routine provision of this service in the context of the Tanzanian National Action Plan on AMR implementation is urgently needed.…”

Section: Open Accessmentioning

confidence: 99%

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

et al. 2020

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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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“…For Belgium, 2017 ECDC-PPS data have been integrated into the Global-PPS tool and therefore were also included in the Belgian dataset. 13 Patient-level data included patient characteristics, information on the prescribed antimicrobials and their indication, as well as a number of quality indicators such as guideline compliance. Survey data were entered and validated using a web application, developed by the University of Antwerp.…”

Section: Methodsmentioning

confidence: 99%

Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries

Pauwels

Versporten

Drapier

et al. 2021

Journal of Antimicrobial Chemotherapy

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Objectives The WHO Access, Watch and Reserve (AWaRe) classification has been developed to support countries and hospitals in promoting rational use of antibiotics while improving access to these essential medicines. We aimed to describe patterns of worldwide antibiotic use according to the AWaRe classification in the adult inpatient population. Methods The Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS) collects hospital antibiotic use data using a standardized PPS methodology. Global-PPS 2015, 2017 and 2018 data, collected by 664 hospitals in 69 countries, were categorized into AWaRe groups to calculate proportional AWaRe use, Access-to-Watch ratios and the most common indications for treatment with selected Watch antibiotics. Only prescriptions for systemic antibiotics on adult inpatient wards were analysed. Results Regional Access use ranged from 28.4% in West and Central Asia to 57.7% in Oceania, whereas Watch use was lowest in Oceania (41.3%) and highest in West and Central Asia (66.1%). Reserve use ranged from 0.03% in sub-Saharan Africa to 4.7% in Latin America. There were large differences in AWaRe prescribing at country level. Watch antibiotics were prescribed for a range of very different indications worldwide, both for therapeutic and prophylactic use. Conclusions We observed considerable variations in AWaRe prescribing and high use of Watch antibiotics, particularly in lower- and upper-middle-income countries, followed by high-income countries. The WHO AWaRe classification has an instrumental role to play in local and national stewardship activities to assess prescribing patterns and to inform and evaluate stewardship activities.

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Point prevalence survey of antimicrobial use and healthcare-associated infections in Belgian acute care hospitals: results of the Global-PPS and ECDC-PPS 2017

Cited by 47 publications

References 10 publications

Antimicrobial use in hospitalized patients: a multicentre point prevalence survey across seven hospitals in Ghana

Antimicrobial use in hospitalized patients: a multicentre point prevalence survey across seven hospitals in Ghana

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

Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries

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