Antibiotics use and its association with Multi-Drug Resistance in a Tertiary Care Geriatrics Hospital in Egypt

Abstract

Introduction: Multi-Drug Resistance (MDR) is common in hospitalized geriatric patients. The study aims to investigate the pattern of antibiotic use and determine its association with MDR in hospitalized geriatric patients. Methodology: A retrospective cohort study including 193 geriatric patients admitted to a Geriatric Intensive Care Unit (GICU) in a tertiary care Geriatrics hospital in Egypt, throughout a consecutive 6 months duration. A review of medical records was done to extract clinical, socio-demographic, and prescribing data on antibiotics throughout admission. The presence of MDR organisms (MDROs) was determined by reviewing culture and sensitivity reports. Descriptive statistics and logistic regression analysis were performed. Results: 181 (93.8%) patients received at least 1 antibiotic. Cephalosporins were the most commonly consumed antibiotics (24%). MDROs were significantly associated with receiving ≥ 3 antibiotics. Longer hospital stay was a predictor of multiple antibiotics use (Odds Ratio of 1.075). MDROs were prevalent in 110 (57.0 %) patients. Klebsiella species were the most frequent MDROs (26%) with the highest susceptibility to amikacin. Conclusions: The study provides a detailed description of both antibiotics use and MDR among hospitalized geriatric patients in Egypt. It gives a novel insight into the ongoing drug-pathogen combinations in acute healthcare settings of the aged. This data has a potential role in applying antimicrobial stewardship programs for hospitalized geriatric patients to mitigate antimicrobial resistance in similar settings.

The pharmacists’ interventions after a Drug and Therapeutics Committee (DTC) establishment during the COVID-19 pandemic

“…The frequent empirical prescribing of broad-spectrum antibiotics in the ICU settings in Egypt contributes to antimicrobial resistance as reported by a previous study in which nearly half of critical care patients received ≥3 antibiotics (Elsorady et al, 2022 ). The hospital in which this study was performed represents a setting of increased need for stewardship because small, nonteaching hospitals have a high rate of antibiotic use (Baggs et al, 2016 ).…”

“…Egypt is in the middle of the list of many countries in terms of antibiotic consumption expressed in defined daily doses (DDD)/1000 inhabitants/day (Klein et al, 2018 ). The misuse of antimicrobials is common in critical care units among LMICs, including Egypt, which is associated with the emergence of antimicrobial resistance (Elsorady et al, 2022 ; Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report, 2021 ). Antibiotics are sometimes sold by community pharmacies without a prescription, which further complicates the problem of antimicrobial resistance (Elsayed et al, 2021 ; Jamshed et al, 2018 ; Lambert et al, 2022 ).…”

Prevalence of multi-drug resistant bacteria in intensive care units at Tripoli University Hospital, Tripoli, Libya

“…Several studies presented different frequencies of MDR among microorganisms in many healthcare settings. In the present study, A. baumannii strains were the most frequent MDROs representing (94%) followed by K. pneumonia strains (90%) of the whole MDR gram negative patient [ 18 ] isolates. Our clinical samples results are consistent with several studies.…”

Antibiotic Resistance Pattern in Intensive Care Units in a Large Referral Hospital in Iran

“…Of course, regardless of the time frame of the COVID-19 pandemic, a wide range of MDR patterns have been reported from different countries. For example, in the study performed by Khalid Elsorady et al in 2022 (27), MDR organisms were prevalent in 110 (57.0 %) patients. Klebsiella species were the most frequent MDROs (26%) with a highest susceptibility to amikacin.…”