Antimicrobial Consumption and Resistance in a Tertiary Care Hospital in Jordan: Results of an Internet-Based Global Point Prevalence Survey

Abstract

Background: The Global Point Prevalence Survey (Global-PPS) provides a standardised method to conduct surveillance of antimicrobial prescribing and resistance at hospital level. The aim of the present study was to assess antimicrobial consumption and resistance in a Jordan teaching hospital as part of the Global-PPS network. Methods: Detailed antimicrobial prescription data were collected according to the Global Point Prevalence Survey protocol. The internet-based survey included all inpatients present at 8:00 am on a specific day in June–July 2018. Resistance data were based on microbiological results available on the day of the PPS. Results: Data were collected for 380 patients admitted to adult wards, 72 admitted children, and 36 admitted neonates. The overall prevalence of antimicrobial use in adult, paediatric, and neonatal wards was 45.3%, 30.6%, and 22.2% respectively. Overall, 36 patients (7.4%) were treated for at least one healthcare-associated infection (HAI). The most frequent reason for antimicrobial treatment was pneumonia. Cephalosporins and carbapenems were most frequent prescribed among adult (50.6%) and paediatric/neonatal wards (39.6%). Overall resistance rates among patients treated for a community or healthcare-associated infection was high (26.0%). Analysis of antibiotic quality indicators by activity revealed good adherence to treatment guidelines but poor documentation of the reason for prescription and a stop/review date in the notes. Conclusion: The present study has established baseline data in a teaching hospital regarding the quantity and quality of prescribed antibiotics in the hospital. The study should encourage the establishment of tailor-made antimicrobial stewardship interventions and support educational programs to enhance appropriate antibiotic prescribing.

Improving the Quality of Medical Documentation in Orthopedic Surgical Notes Using the Surgical Tool for Auditing Records (STAR) Score

“…The study included surgical records for patients undergoing orthopedic surgeries at Jordan University Hospital (JUH), Amman, Jordan. JUH is the first and largest academic hospital in Jordan with a total of 600 beds [ 22 ]. In addition, it is the major referral center for all of central Jordan serving more than four million patients [ 23 ].…”

Opportunities for Antimicrobial Stewardship in Caring for Febrile Pediatric Inpatients in Abu Dhabi

“… 20 In Jordan, it was the timing of discontinuation of antibiotic therapy that held promise as a good target for stewardship program intervention. 8 Similarly, in Europe, antimicrobial stewardship interventions in a children’s hospital led to less antibiotic use, less cost, and improved patient outcomes. 3 In a North American study, vancomycin use and the treatment of otorhinolaryngology infections were the targets identified as most amenable to helpful stewardship interventions.…”

“… 7 As an example, in a Jordanian study, 31% of pediatric inpatients received antibiotics, however the indications were not well-documented in medical records, and the timing of discontinuation was not consistent with recommended procedures. 8 At a US children’s hospital, key targets for improvement in antimicrobial use were found to relate specifically to ear, nose, and throat infections. 9 Thus, evaluation of local antibiotic prescribing habits can identify variations and non-standard practices; then, targeted interventions can potentially improve antimicrobial stewardship.…”

The Value of Auditing Surgical Records in a Tertiary Hospital Setting

“…JUH is the vast pioneer academic hospital in Jordan. Furthermore, it serves more than four million patients by being located in the center of Jordan [23]. JUH houses 600 beds and treats more than half a million patients annually while conducting about 20,000 surgical procedures every single year [24].…”