Point Prevalence Survey of Antibiotic Use in Latin American Hospitals: 2022-2023

Background: Antimicrobial resistance (AMR) is a public health challenge, exacerbated by the inappropriate use of antibiotics (ABs) and the lack of standardized surveillance in healthcare settings. Objective: The Latin American PPS aimed to provide a standardized methodology for monitoring antibiotic use, gather data on antibiotic prescription practices, and support initiatives for antimicrobial stewardship (AMS). Methodology: Using a Spanish-adapted version of the WHO PPS methodology, a point prevalence survey (PPS) was conducted between 2022 and 2023 in 67 hospitals across five Latin American countries. Results: A total of 11,094 patients were surveyed, of which 47.9% received at least one AB; surgical and intensive care units displayed the highest prevalence. Most prescribed AB were third-generation cephalosporins (3GC) (22.0%), carbapenems (12.1%), glycopeptides (9.2%), and penicillin combinations (8.6%). A substantial use of agents classified under the WHO's "Watch" group was found, with notable variances across countries. A multilevel logistic regression model identified that patient age, ICU admission, recent hospitalization, the presence of a catheter, and intubation were significantly associated with higher odds of AB use. In contrast, patients admitted to obstetric or pediatric wards had lower odds of receiving antibiotics. The model revealed considerable heterogeneity between countries, even after adjusting clinical and demographic factors. Conclusions: This study highlights AMS opportunities through targeted interventions, such as optimizing surgical prophylaxis, reducing the use of 3GC, carbapenems, and glycopeptides, and improving adherence to CPGs. These findings provide a comprehensive framework for policymakers and healthcare facilities to develop AMS strategies tailored to the Latin American context.