The point prevalence and inappropriateness of antibiotic use at hospitals in Turkey: a systematic review and meta-analysis

Selçuk, Aysu

doi:10.1080/1120009x.2021.1888031

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…The high prevalence of antimicrobial use found in our study is similar with other global studies that highlight inappropriate use of antimicrobials in the region as a global health problem [ 30 ]. However, the prevalence of antimicrobial use in this study was relatively higher than reported in other regions of the world including Europe and North America [ 30 , 31 ]. Studies have found higher antimicrobial stewardship levels and awareness of antimicrobial use among prescribers in South Africa and this could explain the lower levels of antimicrobial use compared to other countries [ 32 , 33 ].…”

Section: Current Status Of Knowledgecontrasting

confidence: 62%

Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys

Okedo‐Alex¹,

Akamike²,

Iyamu³

et al. 2023

Pan Afr Med J

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Introduction inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to summarize the available evidence on the point prevalence and pattern of antimicrobial and/or antibiotic prescription in Africa. Methods this review was carried out between April and September 2021 and identified published studies up until March 2021 on the point prevalence of antibiotic and/or antimicrobial use in Africa. Sources searched were OVID, PubMed, EMBASE, CINAHL, Web of Science, Google Scholar, Google, and African Journal Online (AJOL). Observational studies that reported prevalence published in English language were included. Covidence systematic review software was used for this review. A form for data extraction using domains culled from the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) was developed on Covidence. Screening of studies for eligibility was done independently by two reviewers. Critical Appraisal tool for use in Joanna Briggs Institute (JBI) Systematic Reviews for prevalence studies was used for quality appraisal. Results a total of 17 studies that met the inclusion criteria were included in the review. The overall prevalence of antimicrobial/antibiotic use among inpatients in these studies ranged from 40.7% to 97.6%. The median antimicrobial/antibiotic use was 61.3 [IQR= 45.5-72.1]. The highest use of antimicrobials was reported among studies from Nigeria with a prevalence of 97.6%. The most prescribed antibiotics were the beta-lactam penicillin (Amoxicillin, clavulanic acid) (86.9%), and third generation cephalosporins (55.0%). There was general preference for parenteral route of administration of the antimicrobial agents (40-70%). Use for community acquired infections (28.0-79.5%) was the main reason for use. Majority of the prophylactic use of antimicrobial agents were for surgical prophylaxis. Conclusion: the high prevalence of antimicrobial use in Africa reinforces the need for continued surveillance and concerted efforts to institutionalize and support antimicrobial stewardship for prescribers in health institutions in the African region.

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Section: Current Status Of Knowledgecontrasting

confidence: 62%

Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys

Okedo‐Alex¹,

Akamike²,

Iyamu³

et al. 2023

Pan Afr Med J

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“…Two separate interview guides (see Supplement) were developed for family physicians and pharmacists based on previous research in the field [10,19,20,[24][25][26]37]. The interview guides were developed in English, translated into the local languages of the participating countries by the researchers and pretested.…”

Section: Data Collectionmentioning

confidence: 99%

“…The median consumption of antibiotics in the European region was reported by the WHO to be 17.9 DDD per 1000 inhabitants per day, whereas consumption in Turkey was more than twice as high (38.2 DDD) [6]. A meta-analysis estimated a pooled point prevalence of antimicrobial use of 45% and a median proportion of 36% inappropriate antimicrobial prescriptions in Turkey [25]. Low health literacy, high subjective demand for antibiotics, availability of antibiotics without prescription, sharing of antibiotics among family members or friends, and high self-treatment rates are the main causes of inappropriate use and overuse of antibiotics in the country [22,23,26].…”

Section: Introductionmentioning

confidence: 99%

Perspectives of physicians and pharmacists on rational use of antibiotics in Turkey and among Turkish migrants in Germany, Sweden and the Netherlands: a qualitative study

et al. 2022

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Background Antimicrobial resistance may result from inappropriate use of antibiotics in health care. Turkey is one of the countries with the highest antibiotic consumption in the world. Considering the role of transnational ties between Turkish migrants and their social contacts in Turkey, the attitudes and behaviors relating to rational antibiotic use in Turkey can also affect the use of antibiotics by Turkish migrants residing abroad. This study explores physicians’ and pharmacists’ experiences and perspectives on rational antibiotic use among Turkish adults in Turkey and among Turkish migrants in Germany, Sweden, and the Netherlands, three European countries with large populations of Turkish migrants. Methods Following a qualitative study design using convenience and snowball sampling, in-depth interviews with 21 family physicians and 24 pharmacists were conducted in the aforementioned countries. We transcribed all interviews verbatim and performed content analysis separately in the countries, followed by translation, pooling and joint interpretation of the findings. Results Physicians and pharmacists encountered irrational use of antibiotics among their patients in Turkey. Physicians interviewed in the three European countries explained that Turkish migrants differ from non-migrants with respect to their attitudes towards antibiotics, for example by more often expecting to be prescribed antibiotics. All physicians and pharmacists in the selected countries reported to inform their patients on how to use antibiotics upon prescription; however, Turkish migrants’ poor language proficiency was considered as a substantial communication barrier by the physicians and pharmacists interviewed in the European countries. Conclusions The study illustrated some aspects of irrational antibiotic use among the population in Turkey and Turkish migrants in selected European countries. It emphasized the need for closer community participation, adequate information campaigns, as well as in-service training of health care providers in Turkey. The strategies and interventions on rational antibiotic use should also be supported and encouraged by health care providers, who need to reach out to people with various cultural backgrounds.

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“…In 2011, data on antimicrobial use in 13 non-European Union countries ranged from 15.3 to 42.3 defined daily dose/1000 inhabitants per day (DID), including Turkey (42.3 DID), with data from Turkey limited to outpatient use (3). A recent systematic review that measured the point prevalence and inappropriate antibiotic prescription in Turkey highlighted high consumption rates and inappropriate antibiotic use over the last 15 years, necessitating the implementation of strict and effective stewardship in all Turkish hospitals (4). Antimicrobial restriction policies are intended to reduce morbidity and mortality, as well as the expense of treatment, the length of hospitalization, and the rate of resistance microorganisms, while also improving quality of life (5)(6).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Antimicrobial Policy Implementation on Carbapenem Resistance: A University Hospital Experience

Derin

ŞEKER

Aksoy

et al. 2022

Clinical and Experimental Health Sciences

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Objective: The resistance of Gram-negative bacteria to antibiotics is a global issue that leads to increased mortality and treatment costs. The aim of this study is to see how a newly formed carbapenem control team affected the prevalence of carbapenem-resistant Gram-negative rods and antibiotic consumption expenses in 2017 compared to the year before. Methods: The rate of carbapenem antibiotic usage in Intensive Care Units and Bone Marrow Transplantation services, as well as the findings of culture materials obtained from various body parts of the same patients, between January 1, 2016, and December 31, 2017 were assessed. Results: While there was an ordinary restriction on carbapenem consumption in 2016, carbapenem consumption has been more restricted in 2017. The carbapenem-resistant Gram-negative bacteria patterns of culture materials are examined and compared with Defined Daily Dose data of carbapenems. After the restriction, a significant decrease in the consumption of carbapenems was detected. The decline in carbapenem-resistant Gram-negative bacteria and decreasing antibiotic consumption were found to have a moderately positive correlation (r=0.641, p=0.02). A 60.9% decrease was observed in carbapenem costs after carbapenem restriction, on the other hand, an increase in other unrestricted antibiotics was apparent. Conclusion: Antimicrobial restriction policies can help minimize the rate of carbapenem-resistant Gram-negative rods, which is a serious problem in healthcare. We demonstrated that a decrease in carbapenem-resistant Gram-negative rods isolation rates can lead to a decrease in healthcare-associated infections. Although there is no decrease in the direct antibiotics cost, a drop in carbapenem-resistant may lower the expenses of drastic consequences of infections with carbapenem-resistant and its cost. we can conclude that the Antibiotic Control Policy should be modified based on this new information.

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The point prevalence and inappropriateness of antibiotic use at hospitals in Turkey: a systematic review and meta-analysis

Cited by 6 publications

References 27 publications

Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys

Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys

Perspectives of physicians and pharmacists on rational use of antibiotics in Turkey and among Turkish migrants in Germany, Sweden and the Netherlands: a qualitative study

The Effect of Antimicrobial Policy Implementation on Carbapenem Resistance: A University Hospital Experience

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