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Longitudinal Point Prevalence Survey of Antimicrobial Consumption in Russian Hospitals: Results of the Global-PPS
Svetlana Rachina1, Yuliya Belkova2, Roman Kozlov2
1Internal Medicine Department, First Moscow State Medical University, 119991 Moscow, Russia.
Abstract:
Antimicrobial resistance is one of the key issues limiting the successful treatment of infectious diseases and associated with adverse medical, social and economic consequences on a global scale. The present study aims to evaluate antimicrobials prescribing patterns and assess progress in quality indicators in Russian multidisciplinary hospitals using three repetitive point prevalence studies (PPSs) over 4 years (Global-PPS 2015, 2017 and 2018). Out of 13,595 patients from 21 hospitals surveyed over the three time points, 3542 (26.14%) received antimicrobials, predominantly third-generation cephalosporins (44.7% in 2015, 34.1% in 2017 and 41.8% in 2018). Compliance with the hospital antibiotic guidelines was 74.8%, 66.8% and 74.3%, respectively. Indication for treatment was recorded in 72.6%, 84.1% and 82.6%, while stop/review date was documented only in 40.5%, 46.5% and 61.1% of cases. Perioperative antibiotic prophylaxis exceeded 1 day in 92%, 84% and 81% of cases. Targeted therapy rate at all time points did not exceed 15.1%, treatment based on the biomarkers rate-19.9%. For the part of PPS-2017 and 2018 analyzed in dynamics, no prominent trends were noted. The results of the project provide the basis for the development of appropriate antimicrobial stewardship programs tailored according to local practices for each hospital in the project.
Insights
Antimicrobial prescribing patterns in Russian hospitals show limited improvement over four years. Key quality indicators like documented stop dates and targeted therapy remain suboptimal, necessitating tailored antimicrobial stewardship programs.
Area of Science:
- Infectious Diseases
- Pharmacology
- Public Health
Background:
- Antimicrobial resistance (AMR) poses a significant global threat to healthcare, leading to adverse medical, social, and economic outcomes.
- Effective antimicrobial prescribing is crucial for combating infectious diseases and mitigating AMR.
- Monitoring prescribing patterns and quality indicators is essential for developing targeted interventions.
Purpose of the Study:
- To evaluate antimicrobial prescribing patterns in Russian multidisciplinary hospitals.
- To assess the progress in key quality indicators related to antimicrobial use over a four-year period.
- To provide data for the development of localized antimicrobial stewardship programs.
Main Methods:
- Utilized three repetitive point prevalence studies (PPSs) conducted in 2015, 2017, and 2018.
- Surveyed 13,595 patients across 21 Russian multidisciplinary hospitals.
- Analyzed data on antimicrobial utilization, compliance with guidelines, indication documentation, stop dates, prophylaxis duration, and targeted therapy rates.
Main Results:
- 26.14% of patients received antimicrobials, with third-generation cephalosporins being predominant.
- Compliance with hospital antibiotic guidelines varied (74.8% in 2015, 66.8% in 2017, 74.3% in 2018).
- Documentation of indication and stop/review dates showed improvement but remained incomplete; prolonged perioperative prophylaxis and low targeted therapy rates were observed.
Conclusions:
- No significant trends in antimicrobial prescribing quality indicators were noted between 2017 and 2018.
- Suboptimal documentation and prescribing practices highlight the need for enhanced antimicrobial stewardship.
- The study findings support the development of hospital-specific antimicrobial stewardship programs based on local prescribing habits.
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