Addressing Antimicrobial Resistance: A Point Prevalence Survey Using AWaRe Indicators from Outpatient Settings of...

Area of Science:

• Global Health
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial resistance (AMR) is a major public health threat in low- and middle-income countries (LMICs).
• Primary care settings significantly contribute to inappropriate antibiotic use.
• Pakistan faces escalating challenges with AMR, necessitating an evaluation of prescribing practices.

Purpose of the Study:

• To assess antibiotic prescribing patterns in hospital outpatient departments (OPDs) in Multan, Pakistan.
• To evaluate the appropriateness of antibiotic prescriptions using WHO AWaRe indicators.
• To identify areas for improvement in antibiotic stewardship programs (ASPs).

Main Methods:

• Data collected from two hospitals' OPDs in Multan over two 4-month periods (Sept-Dec 2023, Jan-Apr 2024).
• Employed the Global Point Prevalence Survey (GPPS) methodology for data collection.
• Applied WHO AWaRe indicators to assess prescription appropriateness in primary care settings.

Main Results:

• 33.85% of 1208 patients received antibiotics; 532 antibiotics were prescribed.
• Amoxicillin-clavulanic acid was the most frequent prescription; 65.2% were 'Access' group antibiotics.
• Only 7.7% of prescriptions complied with WHO AWaRe recommendations, with high use for viral respiratory infections.

Conclusions:

• Frequent antibiotic prescribing observed in Multan's primary care OPDs.
• Inadequate compliance with WHO AWaRe recommendations, despite high use of 'Access' antibiotics.
• Targeted antibiotic stewardship efforts are crucial to reduce inappropriate prescribing.