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A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

Zikria Saleem1,2, Mohamed Azmi Hassali1, Ann Versporten3

  • 1a School of Pharmaceutical Sciences , Universiti Sains Malaysia , Penang , Malaysia.

Expert Review of Anti-Infective Therapy
|February 14, 2019
PubMed

Insights

This study found high rates of unnecessary antibiotic use and broad-spectrum prescribing in Pakistan. Urgent action is needed to implement the national action plan on antimicrobial resistance.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Pharmacology

Background:

  • Antimicrobial resistance is a global health threat.
  • Pakistan, the sixth most populous country, lacks comprehensive data on antimicrobial use.
  • This study addresses the need for data aligned with global action plans.

Purpose of the Study:

  • To conduct the first comprehensive antimicrobial point prevalence survey (PPS) in Pakistan.
  • To assess antibiotic prescribing patterns and indications in Pakistani hospitals.
  • To inform the national action plan on antimicrobial resistance.

Main Methods:

  • A point prevalence survey (PPS) was conducted in 13 hospitals across 7 cities in Pakistan.
  • Data included all inpatients receiving antibiotics on the survey day.
  • A web-based application facilitated data entry, validation, and reporting.

Main Results:

  • 77.6% of 1954 inpatients received antibiotics.
  • Top indications: obstetric/gynecological prophylaxis (16.5%), gastrointestinal (12.6%), lower respiratory tract infections (12.0%).
  • Ceftriaxone (35.0%), metronidazole (16.0%), and ciprofloxacin (6.0%) were most prescribed. 57.4% of antibiotic use was for prophylaxis, with 97.4% of surgical prophylaxis exceeding one day.

Conclusions:

  • Unnecessary prophylactic antibiotic use is prevalent in Pakistani hospitals.
  • Broad-spectrum antibiotic prescribing is common.
  • Urgent implementation of Pakistan's national action plan on antimicrobial resistance is required.
Abstract

Keywords:
PakistanPoint prevalence surveyantimicrobial prescribingantimicrobial resistancehospitals

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