AUDIT OF INFECTION CONTROL EFFECTIVENESS AND ANTIMICROBIAL DRUGS ADMINISTRATION IN UKRAINE: A PROSPECTIVE FOLLOW-UP

Abstract

Indicators of antibiotic resistance in the world and in Ukraine are steadily increasing. As of 2021, there is a national standard in Ukraine that recognizes the deescalation of antibiotic therapy, but the war in Ukraine has significantly disrupted the supply of essential services. War-related infections and antimicrobial resistance are seriously affecting the health of people in Ukraine and beyond, forming a great reservoir of multidrug-resistant gram-negative infections Aims: monitor the effectiveness of infection control and antibiotic administration in the Public Health Department of Ukraine. Methods: Based on the Department of Surgery, Anesthesiology and Intensive Care of the PDO National Medical University named after O.O. Bogomolets, a prospective observational study was carried out - an anonymous audit of doctors, anesthesiologists and doctors of other specialties who work at the Public Health Service of Ukraine from the beginning of 2024. The investigation was carried out on the online platform Google-form. After the completion of the tracking period, all completed data was transferred to an Excel table and analyzed using additional descriptive statistics for parametric data. Results: The results of 214 participants from different regions of Ukraine were collected. Half of the respondents reported that the department of infection control functions effectively - 105 (49.2 %), formally important - 85 (39.9 %), and does not function in 3 (1.5 %) Cefazolin as the first choice AB (57.7 %), using of Ceftriaxone (18.6 %) or Cefuroxime (7.9 %) as the 1st line of AB prophylaxis. About not using the protocol tell for us the choice of AB 2-line AB prevention and treatment of Gram+ and Gram-infection. The most common resistant pathogens in the Ukrainian health care sector were: Klebsiella pneumonia 140 (65.4 %) and Pseudomonas aeruginosa 99 (46.3 %) species. Most respondents also reported the expansion of three courses of AB therapy: 7-10 days in 97 (45.5 %) and 10 days and more – 85 (39.9 %) types. Conclusion: most health protection regulations in Ukraine today include the creation of infection control and approval of local documents (new clinical protocols, patient routes) from infection control and administration Instruction of AB. However, wider problems are avoided without the continuation of specific protocols, the use of AB group reserve for AB prophylaxis, the choice of non-optimal empirical AB therapy, the wider acceptance of combination therapy without indications, trivial courses therapy and type of de-escalation.