Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

Tomas, Ana; Pavlović, Nebojša; Stilinović, Nebojša; Horvat, Olga; Paut-Kusturica, M Milica; Dugandžija, Tihomir; Tomić, Z.; Sabo, Ana

doi:10.3390/antibiotics10040397

Cited by 23 publications

(26 citation statements)

References 38 publications

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“…The problem of such high AMR in Serbia stems, at least in part, from poor overall antimicrobial stewardship. Prescribing rates have significantly grown over the past decade are much higher than the European average [29]. Furthermore, the excessive and irrational use of antibiotics occurs through self-prescribing practices that are still possible in our country, but also poor adherence to national guidelines for rational antimicrobial use [30,31].…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

et al. 2021

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Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R2 = 0.980, p = 0.01) and carbapenems (R2 = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

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Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

et al. 2021

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“…In the Republic of Serbia, total AMU in human medicine was found to be well above the European average [ 29 , 30 ], while the data from veterinary medicine cannot be compared with Europe. Actually, the Medicines and Medical Devices Agency of Serbia collects and processes data from stakeholders who are obliged to keep records on the type and quantity of veterinary medicinal products sold in the Republic of Serbia [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Farm Animal Veterinarians’ Knowledge and Attitudes toward Antimicrobial Resistance and Antimicrobial Use in the Republic of Serbia

et al. 2022

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Antimicrobial resistance (AMR) is considered one of the most prevalent global health issues in both veterinarian and human medicine. This complex problem requires a “One Health” approach with the cooperation of all healthcare sectors, as well as agriculture, finance, and consumers. We conducted a survey with the objective to assess the knowledge and attitudes of farm animal veterinarians toward AMR and antimicrobial use in the Republic of Serbia with a small focus on mastitis therapy. A total of 110 respondents completed the questionnaire, which represents a response rate of 27.3%. The majority of our respondents (n = 102, 92.7%) completely agreed that AMR currently represents severe concern in the health sector. Unfortunately, less than one-third (n = 34, 30.9%) of the respondents had only heard about antimicrobial stewardship. Participants showed a positive attitude toward prudent antimicrobial use and were open to solutions to the AMR crisis. We noticed a certain gap between farm veterinarians’ desire to improve and perform better in daily practice, while at the same time feeling like they did not have enough guidance, help, and resources.

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“…Up to 75% of patients with COVID-19 are treated with antibiotics, even though the rate of coinfections is low and no clinical benefit has been confirmed [ 2 , 3 , 4 ]. Most countries in the European Union (EU) have managed to reduce antibiotic prescribing in the years prior to the pandemic [ 5 ], but the opposite is true for Serbia [ 6 ]. Higher AMR rates are seen in Serbia compared to almost all EU countries in the latest European Centre for Disease Prevention and Control (ECDC) and the World Health Organisation (WHO) reports [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic (Mis)Use in COVID-19 Patients before and after Admission to a Tertiary Hospital in Serbia

et al. 2022

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Antimicrobial resistance (AMR) is a global concern, and antibiotic use has risen throughout the COVID-19 pandemic. Up to 75% of COVID-19 patients are treated with antibiotics despite little evidence for their use. A retrospective study from 6 March 2020 (the start of the pandemic in Serbia) to 31 December 2021 was conducted at the Clinic for Infectious and Tropical Diseases, University Clinical Centre of Serbia. In total, 523 patients with a microbiological diagnosis of COVID-19 were included. Patient data were analysed, including antibiotic use before and after admission. Pre-admission use of antibiotics for COVID-19 treatment was documented in more than half of patients (58.1%), of which a third (34.1%) used more than one antibiotic. Macrolides, cephalosporins, and fluoroquinolones were mainly used, most frequently among patients aged between 31–45 years (75.2%). Prior antibiotic use was associated with a longer duration of illness at admission (8.8 vs. 5.7, p < 0.001), oxygen therapy upon admission (27.6% vs. 16.0%, p = 0.002), and a lower vaccination rate (60.7% vs. 50.7%, p = 0.04). When hospitalised, 72.1% of patients received antibiotics, primarily cephalosporins (71.9%). Significant efforts are needed to reduce antibiotic use in the community and improve prescribing rates by healthcare professionals.

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Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

Cited by 23 publications

References 38 publications

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

Farm Animal Veterinarians’ Knowledge and Attitudes toward Antimicrobial Resistance and Antimicrobial Use in the Republic of Serbia

Antibiotic (Mis)Use in COVID-19 Patients before and after Admission to a Tertiary Hospital in Serbia

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