Antibiotic use among older adults on an acute care general surgery service

Pollmann, André S.; Bailey, Jonathan G.; Davis, Phil; Johnson, Paul M.

doi:10.1503/cjs.004317

Cited by 7 publications

(2 citation statements)

References 51 publications

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“…We are aware of the high and often inappropriate prescribing and dispensing of antibiotics in ambulatory care [1,[21][22][23][24][25]] driving up AMR rates. However, there is also high and inappropriate use of antibiotics in hospitals in both high income [26][27][28][29][30][31][32][33] as well as in low and middle income countries (LMICs), driven in some countries by high rates of sexually transmitted infections, HIV, TB and malaria among in-patients [34][35][36][37][38][39][40][41]. A key step to improving antimicrobial use in hospitals is to monitor current utilization patterns and instigate activities to improve this where pertinent via Drugs and Therapeutics Committees (DTCs) and antimicrobial stewardship programmes (ASPs) [11,35,39,[42][43][44][45][46].…”

Section: Introductionmentioning

confidence: 99%

Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

Paramadhas

Tiroyakgosi

Mpinda-Joseph

et al. 2019

Expert Review of Anti-infective Therapy

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Objective: There is an urgent need to undertake Point Prevalence Surveys (PPS) across Africa to document antimicrobial utilisation rates given high rates of infectious diseases and growing resistance rates. This is the case in Botswana along with high empiric use and extended prophylaxis to prevent surgical site infections (SSIs) Method: PPS was conducted among all hospital sectors in Botswana using forms based on Global and European PPS studies adapted for Botswana, including rates of HIV, TB, malaria, and malnutrition. Quantitative study to assess the capacity to promote appropriate antibiotic prescribing. Results: 711 patients were enrolled with high antimicrobial use (70.6%) reflecting an appreciable number transferred from other hospitals (42.9%), high HIV rates (40.04% among those with known HIV) and TB (25.4%), and high use of catheters. Most infections were community acquired (61.7%). Cefotaxime and metronidazole were the most prescribed in public hospitals with ceftriaxone the most prescribed antimicrobial in private hospitals. Concerns with missed antibiotic doses (1.96 per patient), high empiric use, extended use to prevent SSIs, high use of IV antibiotics, and variable infrastructures in hospitals to improve future antibiotic use. Conclusion: High antibiotic use reflects high rates of infectious diseases observed in Botswana. A number of concerns have been identified, which are being addressed.

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Section: Introductionmentioning

confidence: 99%

Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

Paramadhas

Tiroyakgosi

Mpinda-Joseph

et al. 2019

Expert Review of Anti-infective Therapy

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“…Ceftriaxone was the most usually administered third generation cephalosporin in most surgeries; however, cefotaxime or cefoperazone was apparently the most regularly prescribed third generation cephalosporin in a few studies [17,[27][28][29][30]. It has been reported that the most common therapeutic errors in general surgery were administration of second-or third-line antibiotics without indication and use of antibiotics when they were not required [31,32]. Therefore, it is plausible that geographical differences in bacterial susceptibility and resistance, and infectious disease prevalence in different regions and nations could affect the prescribing behaviors [6,7,28].…”

Section: Discussionmentioning

confidence: 99%

Hospital Antibiotic Prescribing Pattern in General Surgery Specialty: Analysis Based on the WHO Access, Watch and Reserve (AWaRe) Classification

Mounika¹,

Juveriya²,

Uppu³

et al. 2021

JPRI

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Background: Surgical site infections are a prevalent cause of nosocomial infections that require antibiotic prophylaxis. Emergence and spread of antimicrobial resistance is a major global public health issue that must be addressed. Eventually, antibiotic prescribing pattern should be examined in order to ensure that antibiotics are used appropriately and that their effectiveness is preserved. Objective: To evaluate hospital antibiotic prescribing pattern emphasizing on cephalosporins in general surgery specialty using the WHO Access, Watch, and Reserve (AWaRe) classification. Methodology: A cross-sectional study was carried out in 658 hospitalized patients who received prophylactic antibiotics in general surgery specialty for six months. The data were analysed using the ‘WHO prescribing indicators’ and examined for the WHO ‘AWaRe’ categories. The acquired data was subjected to descriptive statistics. Results: Per encounter, the average number of drugs and antibiotics prescribed were 3.8 and 1.3, respectively. 83.4% encounters were with at least one antibiotic and 94.5% encounters had parenteral antibiotics. 31.3% and 77.8% antibiotics were prescribed by generic name and from the Essential Medicines List, respectively. The most frequently prescribed antibiotics were the third generation cephalosporins (36.8%) wherein ceftriaxone (22.0%) and cefoperazone (7.2%) were the two most commonly prescribed. A total of 14 specific antibiotics, ‘Access’ 5 and ‘Watch’ 9 were prescribed. Based on the WHO AWaRe classification, 42.3% ‘Access’ and 57.7% ‘Watch’ group antibiotics prescribed. All the prescribed cephalosporins (100%) were from the ‘Watch’ category. Amikacin (13.5%) and ceftriaxone (22.0%) were the most commonly prescribed ‘Access’ and ‘Watch’ group antibiotics, respectively. Amoxicillin index was 7.5 and ‘Access-to-Watch’ index was 0.7, which were much below the priority values. Conclusion: The antibiotic prescription pattern seen in this study did not entirely meet the WHO recommendations. Antibiotics from the ‘Watch’ category, notably cephalosporins, were commonly prescribed. To retain antibiotic effectiveness and encourage rational antibiotic use, as well as to overcome antibiotic resistance, changes and surveillance antibiotics prescribing are required.

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Is the education of human and animal healthcare professionals about antimicrobial resistance and stewardship adequate during their pre-service training?

Kotwani¹,

Kapur²,

Singhal

et al. 2021

Indian Journal of Medical Microbiology

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Antibiotic use among older adults on an acute care general surgery service

Cited by 7 publications

References 51 publications

Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

Hospital Antibiotic Prescribing Pattern in General Surgery Specialty: Analysis Based on the WHO Access, Watch and Reserve (AWaRe) Classification

Is the education of human and animal healthcare professionals about antimicrobial resistance and stewardship adequate during their pre-service training?

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