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Point Prevalence Survey of Antimicrobial Use in Selected Tertiary Care Hospitals of Pakistan Using WHO Methodology:
Saadia Ambreen1, Numrah Safdar1, Aamer Ikram1
1National Institute of Health, Park Road, Islamabad 45501, Pakistan.
Insights
Antibiotic use in Pakistani hospitals is high, with 75% of patients receiving antibiotics, often for surgical prophylaxis. Urgent interventions are needed to curb excessive antimicrobial prescribing and develop hospital guidelines.
Area of Science:
- Infectious Diseases
- Hospital Pharmacy
- Public Health
Background:
- Inappropriate antibiotic use fuels antibiotic resistance, increases mortality, and raises healthcare costs.
- Understanding current antibiotic prescribing patterns is crucial for effective hospital interventions.
Purpose of the Study:
- To assess antibiotic use patterns in leading Pakistani hospitals.
- To inform policy-making and interventions for improved antibiotic prescription.
Main Methods:
- A point prevalence survey was conducted in 14 tertiary care hospitals.
- Data were collected from patient medical records using a standardized online tool (KOBO).
- Inferential statistics were used to analyze risk factors associated with antimicrobial use.
Main Results:
- Antibiotic use prevalence averaged 75% across surveyed hospitals.
- Third-generation cephalosporins were the most prescribed class (38.5%).
- Surgical prophylaxis was the most common indication (33%), and 61.9% of antimicrobials lacked hospital guidelines.
Conclusions:
- There is an urgent need to address the overuse of empiric antimicrobials and surgical prophylaxis.
- Developing antibiotic guidelines and implementing antimicrobial stewardship programs are essential.
- Interventions should focus on optimizing antibiotic prescribing practices in hospitals.
Abstract:
Background and objectives: The inappropriate use of antibiotics in hospitals can potentially lead to the development and spread of antibiotic resistance, increased mortality, and high economic burden. The objective of the study was to assess current patterns of antibiotic use in leading hospitals of Pakistan. Moreover, the information collected can support in policy-making and hospital interventions aiming to improve antibiotic prescription and use. Methodology and materials: A point prevalence survey was carried out with data abstracted principally from patient medical records from 14 tertiary care hospitals. Data were collected through the standardized online tool KOBO application for smart phones and laptops. For data analysis, SPSS Software was used. The association of risk factors with antimicrobial use was calculated using inferential statistics. Results: Among the surveyed patients, the prevalence of antibiotic use was 75% on average in the selected hospitals. The most common classes of antibiotics prescribed were third-generation cephalosporin (38.5%). Furthermore, 59% of the patients were prescribed one while 32% of the patients were prescribed two antibiotics. Whereas the most common indication for antibiotic use was surgical prophylaxis (33%). There is no antimicrobial guideline or policy for 61.9% of antimicrobials in the respected hospitals. Conclusions: It was observed in the survey that there is an urgent need to review the excessive use of empiric antimicrobials and surgical prophylaxis. Programs should be initiated to address this issue, which includes developing antibiotic guidelines and formularies especially for empiric use as well as implementing antimicrobial stewardship activities.
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