The 2017 global point prevalence survey of antimicrobial consumption and resistance in Canadian hospitals

Abstract

Background: Patient-level surveillance (indication, appropriate choice, dosing, route, duration) of antimicrobial use in Canadian hospitals is needed to reduce antimicrobial overuse and misuse. Patient-level surveillance has not been performed on a national level in Canada. The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) is an international collaborative to monitor antimicrobial use and resistance in hospitals worldwide. Global-PPS locally documents on a single day patient-level antimicrobial prescribing practices. This article presents the results of the 2017 Global-PPS in Canadian hospitals with established antimicrobial stewardship programs. Methods: Hospitals part of the Canadian Nosocomial Infection Surveillance Program were invited to participate. Surveys could be performed any time in the 2017 calendar year. All in-patient wards in each hospital were surveyed by a physician, pharmacist or nurse with infectious disease training. Results: Fourteen Canadian hospitals participated in the survey. Of 4118 patients, 1400 patients (34.0%) received a total of 2041 antimicrobials. Overall, 73.1% (n = 1493) of antimicrobials were for therapeutic use, 14.2% (n = 288) were for medical prophylaxis, 8.3% (n = 170) were for surgical prophylaxis, 1.8% (n = 37) were for other reasons, and 0.2% (n = 3) were used as prokinetic agents. Only 2.5% (n = 50) were for unknown reasons. For antimicrobials for therapeutic use, 29.9% of patients were treated for lower respiratory tract (343/1147), 10.5% for intra-abdominal (120/1147), 9.3% for skin and soft tissue (107/1147) and 7.5% for gastro-intestinal (86/1147) infections. Conclusions: Standardized methodology amongst Global-PPSs allows the comparison of our results to the 2015 Global-PPS. The prevalence of antimicrobial use on medical, surgical, and intensive care wards are similar to those previously observed in North America. Indication of antimicrobials has not been previously reported on such a large scale in Canadian hospitals. This report serves as a comparison for further point prevalence surveys that are currently underway. It will be used for identifying opportunities and benchmarking in antibiotic stewardship.

The 2018 Global Point Prevalence Survey of antimicrobial consumption and resistance in 47 Canadian hospitals: a cross-sectional survey

“…10 From 2002 to 2017, a substantial decrease in prescriptions for hospital-acquired infections was observed in Canada. 8 When we compared our results with the 2017 survey, 9 this decrease appears to have been maintained in 2018. At the patient level, similar rates of hospital-acquired infections were reported worldwide in 2015 10 and in Europe in 2016-2017.…”

“…Our findings on AMU on medical, surgical and intensive care wards are similar to data previously reported in Canada. As seen in the 2017 pilot study, 9 respiratory tract infections accounted for the majority of the infections treated in all wards except for surgical wards, where intra-abdominal infections were most prevalent. Treatments for surgical site infections were more frequent on surgical wards, while treatments for pneumonias and urinary tract infections were more frequent on medical wards.…”

“…Details of the Global-PPS methods have been described elsewhere. 10,11 The methodology we employed was similar to that used in the Canadian Global-PPS conducted in 2017, 9 using the standardized protocol and forms developed by the Global-PPS partnership 12 (Appendix 1, available at www. cmajopen.ca/content/9/4/E1242/suppl/DC1).…”

Effects of coronavirus disease 2019 (COVID-19) pandemic on antimicrobial prevalence and prescribing in a tertiary hospital in Singapore

“…The Global Point Prevalence Survey (Global-PPS) first conducted in 2015 provides a rapid way to understand the quantity and quality of antimicrobial prescribing [ 6 ]. Using a standardised methodology over the years, the surveys allow comparisons to be made between time periods [ 7 ]. Information from these surveys can be used for tailor made surveillance and help develop prescribing guidelines and educational initiatives to improve antimicrobial use.…”

Effects of Coronavirus Disease 2019 (COVID-19) Pandemic on Antimicrobial Prevalence and Prescribing in a Tertiary Hospital in Singapore

“…[6] Using a standardised methodology over the years, the surveys allow comparisons to be made between time periods. [7] Information from these surveys can be used for tailor made surveillance and help develop prescribing guidelines and educational initiatives to improve antimicrobial use. The antimicrobial stewardship team at Tan Tock Seng Hospital (TTSH) and the National Centre for Infectious Diseases (NCID), Singapore, comprise a team of 5 full-time equivalent (FTE) pharmacists who provided daily prospective review and feedback (PRF) on piperacillin-tazobactam, carbapenem and cipro oxacin use.…”