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Antibiotic point prevalence survey and antimicrobial resistance in hospitalized patients across Peruvian reference
Claudia Rondon1, Coralith Garcia2, Fiorella Krapp1
1Instituto de Medicina Tropical Alexander von Humboldt - Universidad Peruana Cayetano Heredia, Lima, Peru.
Background:
Peru reports higher levels than other countries in Latin America of resistance to antimicrobials among Gram-positive and Gram-negative bacteria, however data on antibiotic use in Peru are scarce. This study aims to estimate the prevalence and quality of antibiotic prescription in hospitalized patients and to determine the antibiotic susceptibility rates of bacteria causing key bacterial infections.
Methods:
We carried out a point prevalence survey of antibiotic prescription at ten public hospitals in nine regions of Peru. Data was collected from patients hospitalized during a 3-week period, with details about antibiotic use, patient information, and antimicrobial susceptibility.
Results:
1620 patient charts were reviewed; in 924 cases antibiotics were prescribed (57.0 %, range 45.9-78.9 %). Most of the antibiotics (74.2 %) were prescribed as empirical treatment, only 4.4 % as targeted treatment. For 9.5 % of cases the reason for antibiotic use was unknown. Cephalosporins were the most prescribed (30.0 %), followed by carbapenems (11.3 %). Ninety-four blood cultures were positive for bacterial growth, 48.8 % of the Staphylococcus aureus were methicillin-resistant, among Escherichia coli and Klebsiella pneumoniae, 51.7 % and 72.7 % were resistant to third-generation cephalosporins (3GC), 3.4 % and 18.2 % were resistant to carbapenems, respectively. Among bacteria isolated from urine cultures (n = 639), 43.9 % of E. coli and 49.2 % of K. pneumoniae were resistant to 3GC, and 0.9 % of E. coli and 3.2 % of K. pneumoniae were resistant to meropenem.
Conclusions:
The overall proportion of hospitalized patients receiving antibiotics in hospitals from different regions in Peru was high, with only a small proportion receiving targeted treatment. Cephalosporins and carbapenems were the most frequently prescribed antibiotics, reflecting high resistance rates against 3GC and carbapenems in Enterobacterales isolated from blood and urine.
Insights
High antibiotic use in Peruvian hospitals, with over half of patients receiving them, often empirically. Resistance to common antibiotics like cephalosporins and carbapenems is prevalent in key bacterial infections.
Area of Science:
- Infectious Diseases
- Clinical Pharmacy
- Microbiology
Background:
- Peru faces significant antimicrobial resistance challenges, particularly with Gram-positive and Gram-negative bacteria.
- Limited data exists on antibiotic consumption patterns within Peru.
- This study addresses the critical need for understanding antibiotic use and resistance in Peruvian healthcare settings.
Purpose of the Study:
- To estimate the prevalence and assess the quality of antibiotic prescriptions in hospitalized patients across Peru.
- To determine the antibiotic susceptibility rates of common bacterial pathogens causing significant infections.
- To provide data for antimicrobial stewardship initiatives in Peru.
Main Methods:
- A point prevalence survey was conducted across ten public hospitals in nine Peruvian regions.
- Patient data, including antibiotic prescriptions and reasons for use, were collected over a three-week period.
- Antimicrobial susceptibility testing was performed on bacterial isolates from blood and urine cultures.
Main Results:
- Antibiotics were prescribed to 57.0% of 1620 reviewed patient charts, with 74.2% used empirically.
- Cephalosporins (30.0%) and carbapenems (11.3%) were the most frequently prescribed antibiotic classes.
- High resistance rates were observed: 48.8% of Staphylococcus aureus were methicillin-resistant; significant resistance to third-generation cephalosporins and carbapenems was found in Escherichia coli and Klebsiella pneumoniae.
Conclusions:
- A high proportion of hospitalized patients in Peru receive antibiotics, predominantly for empirical treatment.
- The study highlights a concerning prevalence of antibiotic resistance to commonly used drugs like cephalosporins and carbapenems.
- Findings underscore the urgent need for improved antibiotic stewardship programs in Peru to combat rising antimicrobial resistance.
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