Serial Point‐Prevalence Studies to Investigate Hospital Antimicrobial Prescribing

Abstract

Aim: To investigate antimicrobial prescribing patterns using a validated point-prevalence approach and to identify intervention targets to optimise antimicrobial use. Method: 3 prospective point-prevalence studies were conducted over 4-day periods in April 2005, September 2005 and April 2006 at a tertiary hospital using a previously published method. Clinical pharmacists used a standardised data collection form on an allocated day to record details of all patients who were prescribed systemic antimicrobials (antivirals, antifungals, antibacterials) and the total number of patients seen. The appropriateness of the IV route was assessed using pre-defined criteria. Results: Over the 3 study periods 1515 drug charts were reviewed. Of these, 508 (34%) patients were prescribed 832 antimicrobial courses. The mean patient age was 67.5 (SD 32.3) years and 55% were males. Treatment accounted for 730 (88%) courses and prophylaxis for 102 (12%). The most frequently prescribed antimicrobials were ceftriaxone (9.7%) and amoxycillin/clavulanate (7.5%). The most commonly prescribed antimicrobial classes were penicillins (26%) and cephalosporins (20%). 342 (41%) courses were restricted antimicrobials and 85% of these had appropriate approval. 478 (58%) courses were given IV with clinical pharmacists identifying that 2.9% of these could have been given orally. Conclusion: Serial point-prevalence studies proved to be an effective tool for examining baseline patterns of antimicrobial use. This efficient and reproducible tool would be appropriate for other hospitals to use as a component of their antimicrobial usage monitoring.

Snapshot of Antimicrobial Stewardship in Australian Hospitals

“…Around 30 to 40% of hospitalised patients are prescribed antimicrobials. 1,2 Studies have demonstrated that up to 50% of antimicrobial use in overseas hospitals is inappropriate, with similar rates of inappropriate antimicrobial use reported in Australian hospitals. [3][4][5][6][7] Therefore, a need to optimise antimicrobial use is clearly evident, especially when there is limited development of new antimicrobials.…”

Evaluation of Antimicrobial Stewardship Programs (ASPs) and their perceived level of success at Makkah region hospitals, Kingdom of Saudi Arabia

“…The main reason for resistance is excessive and irrational antimicrobial use at hospitals and at the community level. ( Smith and Coast, 2002 , Dean et al, 2002 , Ho and Melvani, 2007 , Storr et al, 2017 , O’Neill, J., 2014 ). Inappropriate use of antibiotics is also common in settings in the KSA and strengthens this concern at the global level ( Belkina et al, 2014 , Al-Ghamdi et al, 2002 ).…”

Antimicrobial stewardship program activities in India: an appraisal

“…This makes it one of the world's most urgent public health problems. 2 Antimicrobial resistance threatens the very core of modern medicine and the sustainability of an effective, global public health response to the enduring threat from infectious diseases. Without harmonized and immediate action on a global scale, the world is heading towards a post-antibiotic era in which common infections could once again kill.…”

“…The main reason for resistance is unnecessary and irrational antimicrobial use at hospitals and at the community level. 1,2 To address the increasing burden of multidrug resistant infections antibiotic stewardship programs are promoted worldwide to rationalize prescription of antibiotics and preserve remaining antibiotics.…”