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.
Highlights
Inappropriate utilisation of antibiotics is an important and changeable driver for antimicrobial resistance (AMR), linked with higher rates of mortality and morbidity [1] in addition to the extra unjustified cost [2,3]
AMR is of particular concern in low- to-middle income countries, including Jordan, as a result of the recent increase in the use of marketed antimicrobial agents inappropriately [4,5,6,7,8], this rising in the rates of AMR has enhanced the development of national and international initiatives to improve the use of antibiotics in the future by implementing programs of antimicrobial stewardship [9,10,11]
Several opportunities for improvement became obvious during the study, including developing local prescribing guidelines and adherence to these
Summary
Inappropriate utilisation of antibiotics is an important and changeable driver for antimicrobial resistance (AMR), linked with higher rates of mortality and morbidity [1] in addition to the extra unjustified cost [2,3]. Prevalence Survey (PPS) of Antimicrobial Consumption and Resistance is to identify the international prevalence of the antimicrobial use, with an emphasis on countries with low support, resources, and expertise. This method of a PPS was used in the present study during 2018 to report the antibiotic prescribing practices for inpatients admitted to hospital wards. 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. The overall prevalence of antimicrobial use in adult, paediatric, and neonatal wards was 45.3%, 30.6%, and 22.2%
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