Point Prevalence Survey of Antimicrobial Use in Selected Tertiary Care Hospitals of Pakistan Using WHO Methodology: Results and Inferences

Abstract

Background and objectives: The inappropriate use of antibiotics in hospitals can potentially lead to the development and spread of antibiotic resistance, increased mortality, and high economic burden. The objective of the study was to assess current patterns of antibiotic use in leading hospitals of Pakistan. Moreover, the information collected can support in policy-making and hospital interventions aiming to improve antibiotic prescription and use. Methodology and materials: A point prevalence survey was carried out with data abstracted principally from patient medical records from 14 tertiary care hospitals. Data were collected through the standardized online tool KOBO application for smart phones and laptops. For data analysis, SPSS Software was used. The association of risk factors with antimicrobial use was calculated using inferential statistics. Results: Among the surveyed patients, the prevalence of antibiotic use was 75% on average in the selected hospitals. The most common classes of antibiotics prescribed were third-generation cephalosporin (38.5%). Furthermore, 59% of the patients were prescribed one while 32% of the patients were prescribed two antibiotics. Whereas the most common indication for antibiotic use was surgical prophylaxis (33%). There is no antimicrobial guideline or policy for 61.9% of antimicrobials in the respected hospitals. Conclusions: It was observed in the survey that there is an urgent need to review the excessive use of empiric antimicrobials and surgical prophylaxis. Programs should be initiated to address this issue, which includes developing antibiotic guidelines and formularies especially for empiric use as well as implementing antimicrobial stewardship activities.

Point prevalence survey of antibiotics use among hospitalised neonates and children in Saudi Arabia: findings and implications

“…Similarly, within our study, antibiotic usage was notably elevated in the medical subspecialty paediatric unit, at 52.3%, and in the ICU, at 42.4%. This contrasts with findings from other studies, where antibiotic utilisation was reported to be higher in the ICU, ranging from 99% (Ambreen et al, 2023 ), 62% (Prusakov et al, 2021 ), 78.5% (Wang et al, 2021 ). The heightened use of antibiotics among children and neonates in the ICU and medical subspecialty units may be attributed to the critical health status of patients, the presence of severe infections, and concurrent medical conditions (Arif et al, 2021 ; Saleem et al, 2020 ).…”

“…The findings from our PPS conducted in selected hospitals revealed a high prevalence of antibiotic usage among children and neonates, reaching 94.6%. In comparison to other studies, our results indicate a higher prevalence of antibiotic use, exceeding that of Botswana (70.6%) (Anand Paramadhas et al, 2019 ), Pakistan (75%) (Ambreen et al, 2023 ), Kenya (46%) (Omulo et al, 2022 ), Greece (40%) (Osowicki et al, 2015 ) and Australia (46%) (Gkentzi et al, 2019 ). Similarly, within our study, antibiotic usage was notably elevated in the medical subspecialty paediatric unit, at 52.3%, and in the ICU, at 42.4%.…”