Appropriate Use Of Antibiotics Research Articles

Self-assessed levels of preparedness, engagement willingness and teaching preferences on antibiotic use of medical and pharmacy students in Romanian universities: a cross-sectional study

BackgroundTo effectively support health professionals in optimizing antibiotic prescribing and dispensing, policymakers need to understand how these professionals are trained, feel prepared and want to be educated. The study aimed to assess the current situation and explore potential improvements in antibiotic use among future health professionals in Romania by: (i) evaluating their self-assessed preparedness on antibiotic-related topics, (ii) understanding their perceptions of their role in antibiotic stewardship, and (iii) gathering their recommendations for optimizing antibiotic use.MethodsA survey of students’ self-assessment of technical preparedness, engagement willingness, expectations, teaching preferences, training received and evolution of situation in Romania. Overall, 41 and 38 questions were asked to medical and pharmacy students respectively. Scores were calculated for preparedness, engagement willingness and teaching preferences to enable various comparisons. Exploratory factor analysis was used to explore the questionnaire construct.ResultsA total of 479 participants completed the survey- 233 medical students from 7 universities and 246 pharmacy students from 4 universities. Median overall preparedness score indicated that most students felt prepared in at least 14 questions (out of 22 for medical students, and 19 for pharmacy students). Engagement scores for medical and pharmacy students were similar (2 and 3 out of 4). Overall, more than half reported that ‘yes, very likely’ they received adequate training to ensure the appropriate use of antibiotics in their professional areas (n = 254, 53.5%). Medical and pharmacy students with low preparedness scores expressed a need for more education. Most of both medical and pharmacy students considered the antibiotic situation in Romania ‘will get worse’ (n = 159, 33.5%).ConclusionsThe study’s findings have important implications for the education and training of future Romanian health professionals and highlight the need for further research on optimal and standardized tools to allow for periodic monitoring and evaluation of progress into preparedness, engagement willingness and teaching preferences on antibiotic use.

A-278 Prevalence of Clostridium Difficile in Long-Term Care Facilities Using BD Max Cdiff Molecular Assay

Abstract Background Clostridium difficile (C.Diff) is a gram positive anaerobe producing Enterotoxin and Cytotoxin (toxin A and B respectively); more than half of million infection is diagnosed yearly with more than 10% of the cases are in patients over 65 years old. Residents in Long-Term Care Facilities (LTCF) are more prone to have C. Diff infection (CDI) because of their age, the frequent use of antibiotics, fragilities, co-morbidity, and living environment. Diagnosing CDI is based on clinical signs and symptoms as well as laboratory tests; however, the enzyme immunoassays are reliable, the tissue culture cytotoxicity is labor intensive. The nucleic acid amplification tests are becoming more the standard as first step in the diagnosis. The BD MAX™ System is a PCR walkaway instrument that provides the sensitivity, specificity and faster turnaround for the C. diff. Methods The BD MAX™ System is an automated in-vitro diagnostic test for the direct qualitative detection of the C. difficile toxin B gene (tcdB) in human liquid or soft stool specimens from patients suspected of having Clostridium difficile Infection (CDI). Premier Toxins A & B is an enzyme immunoassay for the direct detection of Clostridium difficile toxin A and toxin B in stool samples. We collected data from 5,267 samples were collected from resident in LTCF and were run using the EIA assay, 275 samples were ran using the BD Max molecular assay. We had 31 samples that were run using both assays. Statistical analyses were done using Analyse-it. Results Female accounted for 60% of the patients tested; the positivity rate was 13.2% for female and 17.2 for male using the EIA. The positivity rate was 19.2% for female and 30.6% for male when using the molecular assay. The agreement between the EIA and the PCR was 87% based on 31 samples that were run for both assays. Conclusions The BD Max gave the benefit of a fully automated with high sensitivity and specificity for the presence of toxin B producing C. Diff. The difference between the methods could be due to the lack of the sensitivity in the EIA and the fact that the molecular assay might be picking up colonized specimen or the beginning or end of infection. However, the ability to diagnose CDI early and prevent spreading of the disease to other patients is a huge benefit to the facilities. We have to keep in mind also that C.diff infection can be prevented with appropriate use of antibiotics and implementing antibiotic stewardship and infection control plan to prevent and stop spreading of the infection.

B-047 A Rapid Host-Response Test Supports Antimicrobial Stewardship at a Micro-Hospital Emergency Department

Abstract Background The management of patients with suspected infections requires identification of the infectious etiology to determine appropriate use of antibiotics. However, differentiating viral from bacterial infection (and co-infection) is often challenging as clinical presentations can be similar and existing diagnostics sometimes fail to identify a clinically relevant pathogen. A host-response test (MeMed BV®, MMBV) that relies on computational integration of three proteins (TRAIL, IP-10 and CRP) measured from blood or serum has demonstrated high diagnostic performance for differentiating bacterial from viral infections, with a negative predictive value >95% across multiple studies. This report evaluates real-world use of MMBV at a micro-hospital Emergency Department (ED) and associated antibiotic prescribing. Methods The study is a retrospective analysis of real-world data collected between January and June 2023. MMBV was ordered by providers at a micro-hospital ED in Tucson, AZ at provider discretion as part of routine care. Prescription among cases with MMBV score <35 was analyzed. This cutoff is indicated by the manufacturer to indicate a viral or other non-bacterial etiology. If an antibiotic was prescribed, the authors conducted a chart review to adjudicate whether the prescription was warranted. Results Data was evaluated between January and June 2023; 116 MMBV tests were ordered by six providers. Most tests (81.9% (95%CI: ±7.0%)) had an MMBV score <35 (mean score 11.3 with standard deviation 10.8). Among these, 92.6% (95%CI: ±5.3%) of cases with viral results were not prescribed antibiotics. MMBV use increased throughout the study period from 12 tests in the first month to 25 in the last month (r = 0.88; p<0.001). There were seven cases where providers chose to prescribe despite a viral MMBV result. Upon chart review, 2/7 were unwarranted prescriptions. Conclusions In the emergency settings, integrating MMBV can effectively guide clinical decision-making, potentially reducing unnecessary antibiotic use. Further research in diverse healthcare settings is needed to validate these findings.

Can patient education initiatives in primary care increase patient knowledge of appropriate antibiotic use and decrease expectations for unnecessary antibiotic prescriptions?

Healthcare globally is increasingly threatened by antibiotic resistance. Misunderstanding of the appropriate use of antibiotics is common within the general population, therefore patient education could be a useful tool to employ against antibiotic resistance. Patient satisfaction with healthcare is important, and antibiotic awareness is crucial to avoid disappointment when antibiotic stewardship is practiced. This review aims to identify whether patient education is an effective tool to improve knowledge and awareness of the appropriate use of antibiotics and whether it has an effect on expectations of or prescription rates of antibiotics. Embase, Medline, Web of Science, PubMed, and Cochrane Library were searched to identify studies examining the impact of various forms of patient education on awareness of appropriate antibiotic use and antibiotic prescription rates. Reference lists of eligible studies were also screened. Three hundred and fourteen unique studies were identified, of which 18 were eligible for inclusion. All studies were of good quality. Three studies examined public health campaigns, five examined leaflets, two examined posters, three examined videos, four used mixed interventions and one study examined a presentation. The results were too heterogenous to perform a meta-analysis. Patient education is an effective tool to increase public knowledge and awareness of the appropriate use of antibiotics, and can reduce the expectation of or prescription rates of antibiotics. The form of patient education matters, as interventions involving active learning and engagement demonstrate significant positive outcomes, whereas passive forms of learning do not appear to have any effect on understanding or prescriptions.

Improving treatment plan and mental health in children with abdominal infection for broad-spectrum bacterial infections

BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment. In surgical treatment, accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects. AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy. METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped. The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing, and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing; the control group only sent bacterial culture and drug sensitivity testing during the operation. RESULTS White blood cell count, C-reactive protein, procalcitonin, 3 days after surgery, showed better postoperative index than the control group (P < 0.05). The hospital stay in the observation group was significantly shorter than that in the control group. The hospitalization cost in the observation group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P < 0.05). CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics, improving treatment outcomes and reducing medical costs to some extent.

Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review.

While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (AP) is recommended, studies indicate a high rate of inadequate treatment. A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data were categorized based on core concepts, and a narrative synthesis was performed. The search identified a total of 1016 publications. After evaluating 203 full texts and additional sources from the grey literature, 80 studies were included in the review. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacterial resistance and fungal infections, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN does not always require microbiological samples, as clinical suspicion or computed tomography signs can suffice. Early diagnosis and treatment may be improved by using biomarkers such as procalcitonin and novel microbiological methods; (3) When indicated, early initiation of antibiotics is a key determinant in reducing mortality associated with IPN; (4) Antibiotics with good penetration into pancreatic tissue covering Gram-negative and Gram-positive bacteria should be used. Routine antifungal therapy is not recommended; (5) The step-up approach, including antibiotics, is the standard for IPN management; (6) Antibiotic duration should be kept to a minimum and should be based on the quality of source control and patient condition. Early antibiotic therapy is essential for the treatment of IPN, but prophylactic antibiotics are not recommended in AP. High-quality randomized controlled trials are required to better understand the role of antibiotics and antifungals in AP management.

Health literacy and its association with antibiotic use and knowledge of antibiotic among Egyptian population: cross sectional study

BackgroundHigh prevalence of inappropriate antibiotic use in different sectors of the community indicates a possible strong influence of social and cultural context, which may be influenced by social determinants of health and thereby affecting individuals’ health-related behavior, including antibiotic use. And such health-related behavior is largely determined by individuals’ health literacy.ObjectiveThe purpose of this research was to examine the relationship between the Egyptian population's health literacy, antibiotic use, and antibiotic knowledge.MethodIn Egypt, researchers used a cross-sectional study design, between the period of January and March 2024 using validated questionnaires and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated questionnaires the HLS-EU-Q16, a shortened version of the European Health Literacy Survey Questionnaire (derived from the World Health Organization's Antibiotic Resistance: Multi-Country Public Awareness Survey) and, familiarity with drugs and understanding of antibiotic resistance via online methods and face-to-face interviews.ResultsThe survey included a participation of 500 persons in total. The participants' age distribution indicated that 28.8% (n = 144) were aged 18–24, while 27.4% (n = 137) were within the 25–34 age group. Moreover, a total of 274 participants, accounting for 54.8% of the sample, described themselves as female. Significantly, 60.7% of the patients indicated acquiring antibiotics without a prescription. The evaluation of health literacy (HL) levels among the participants revealed that 36.2% had problematic HL, while 8.4% showed inadequate HL. A strong positive link was found between the scores of antibiotic knowledge and the scores of HL (R = 0.876; P-value = 0.001).ConclusionOverall, it is imperative to implement awareness-raising curricula and public health education initiatives without delay. Furthermore, it is highly advised to implement public health awareness initiatives about the appropriate use of antibiotics, alongside national policies aimed at regulating the availability and prescription of antibiotics.

Parental Awareness of Antibiotic Use for Upper Respiratory Tract Infection in Children in Jazan Region, Saudi Arabia.

Upper respiratory tract infections are a prevalent cause of morbidity in children, often managed in primary care settings. These infections are predominantly viral, but antibiotics are sometimes inappropriately prescribed. This misuse, driven by parental pressure and misconceptions, contributes to the growing problem of antibiotic resistance. The impact of parental awareness on antibiotic use practices is significant, as gaps in knowledge can lead to inappropriate use. This study used a cross-sectional design to assess parents' awareness of antibiotic use for upper respiratory tract infections in children in Jazan, Saudi Arabia. Data were collected via a self-administered online questionnaire distributed through social media platforms. Participants were parents aged 18 years and older residing in Jazan. A snowball sampling technique was employed. The questionnaire assessed knowledge, attitudes, and practices regarding antibiotics. The study included 398 participants, with a nearly equal gender distribution of 198 females (49.7%) and 200 males (50.3%). Participants' ages were as follows: 148 (37.2%) were 18-30 years old, 162 (40.7%) were 31-40 years old, and 88 (22.1%) were over 40 years old. Regarding educational attainment, 29 (7.3%) mothers and 36 (9.0%) fathers had primary school education; 117 (29.4%) mothers and 128 (32.2%) fathers had secondary school education; 22 (5.5%) mothers and 33 (8.3%) fathers had intermediate school education; 209 (52.5%) mothers and 175 (44.0%) fathers held a bachelor's degree; and 21 (5.3%) mothers and 26 (6.5%) fathers had a master's degree. Most participants had a moderate income level (270, 67.8%) and resided in Bish (202, 50.8%). The main sources of information about antibiotics were doctors (242, 60.8%) and the internet (90, 22.6%). Perceptions varied, with 147 (36.9%) agreeing and 84 (21.1%) strongly agreeing that antibiotics can prevent complications from infections. A significant proportion believed that inappropriate use could lead to antibiotic resistance (172, 43.2% agreed; 129, 32.4% strongly agreed). Regarding the use of leftover antibiotics, 197 (49.5%) disagreed with using them without consulting a doctor. Interaction with pediatricians showed that 212 (53.3%) always followed pediatrician advice and instructions, while 66 (16.6%) rarely did. The study highlights significant gaps in parental awareness regarding antibiotic use for upper respiratory tract infections in Jazan. Despite some understanding of antibiotic resistance, misconceptions about the efficacy and appropriate use of antibiotics persist. Addressing these gaps through targeted education and improving communication with healthcare providers could enhance antibiotic stewardship and reduce the risk of resistance.

Understanding hospital antimicrobial prescribing decisions and determinants of uptake of new local antimicrobial prescribing guidelines in Laos.

Antimicrobial use in Laos is among the highest in Southeast Asia. The first Lao comprehensive antimicrobial prescribing guidelines have been available since 2021. This study explored the determinants of antibiotic prescribing decisions and how the new prescribing guidelines were being used. In August 2022, in-depth interviews were conducted with 16 Lao prescribers from two hospitals. Participants were questioned about their prescribing behaviours, attitudes to guidelines, how they learned about the guidelines and factors influencing their uptake. The interviews were audio-recorded, transcribed, and translated into English. Thematic analysis of the transcripts was conducted. Lao prescribers considered multiple factors before deciding to prescribe antibiotics to their patients. The most common factor was based on the clinical judgement of the prescribers. Lack of certain antibiotics and turnaround times of laboratory results were the main challenges to prescribing antibiotics appropriately. The majority of participants were satisfied with the guidelines, regarding them as comprehensive, simple and convenient. However, most participants admitted that they did not access the guidelines very often. The main reason was that they could remember the treatment recommendations because they treat similar diseases on a daily basis. Improving antibiotic knowledge was the most common recommendation in order to improve the appropriate use of antibiotics. Raising awareness of the guidelines and promoting their use should also be considered. In addition, heads of the wards, and policy and implementation leaders, should support, monitor and feedback their use to encourage all prescribers to follow the guidelines. Several factors contribute to enhancing appropriate antibiotic prescription. Key factors for improving antibiotic prescription include enhancing prescribers' clinical knowledge, ensuring access to essential antibiotics, and updating guidelines regularly. Health leaders must get involved to promote their use.

Nurses’ contribution to antimicrobial stewardship: business as usual?

BackgroundAntimicrobial Stewardship (AMS), the set of actions to ensure appropriate antimicrobial use, is increasingly considered a multidisciplinary endeavour. However, it is unclear how Dutch hospital-based nurses envision their contribution to AMS.ObjectiveTo explore the views and visions of Dutch bedside nurses on their role regarding appropriate antimicrobial use.MethodsA qualitative study using semi-structured interviews was conducted. Fourteen bedside nurses in nine different Dutch hospitals participated. Data were analysed using a thematic content analysis.ResultsNurses considered their role regarding appropriate use of antibiotics as an integral part of their daily nursing practice. They envisioned their future role as an expansion of their current practice, improving or intensifying this contribution. Prompting review of antimicrobial treatment by nurses was seen as regular practice. Ward rounds were considered the best moment to exert their nursing role, by showing leadership in communicating about different aspects of AMS. Patient advocacy (“striving for the best possible care for their patient”) appears to be a driver of the nursing contribution. Nurses perceived a shared responsibility with prescribers on certain aspects of the antimicrobial treatment and wished for a clarification of this role. Education and cognitive reminders such as antibiotic checklist to be used in ward rounds, can support the uptake of the nurses’ role.ConclusionNurses envision their future role in AMS as an enhanced, elaborated and empowered version of their current daily practice. Education, formal acknowledgment and increased awareness of the nursing role, may advance the contributing role nurses already have.

Burden of multidrug-resistant bacteria among HIV-positive individuals in Ethiopia: A systematic review and meta-analysis.

Multidrug-resistant (MDR) bacteria are a significant cause of severe infections, particularly in human immunodeficiency virus (HIV)-positive individuals because of their weakened immunity. Since there was no previous pooled representative data regarding the MDR bacteria among HIV-positive individuals in Ethiopia, this systematic review and meta-analysis is required. This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Medline, EMBASE, Google Scholar, Hinari, Web of Science, Science Direct, and African Journals Online databases. Data were extracted using Microsoft Excel 2019 and analyzed using STATA version 11.0 software. A random-effects model was used to estimate the pooled effect size of outcome variables across studies with a 95% confidence interval. The I2 statistic was used to check for heterogeneity. The presence of publication bias was determined using a funnel plot and Egger's test with a p-value < 0.05 evidence of statistically significant bias. The pooled prevalence of MDR was 58.02% (95% CI: 46.32-69.73%) with high heterogeneity (I2 = 97.1%, (p < 0.001). In subgroup analysis, the highest multi-drug resistance was observed in the Oromia region (80.95%), patients with multiple infections (82.35%), and studies identified both Gram-positive and Gram-negative bacteria (61.45%). Furthermore, the pooled prevalence of MDR bacteria colonizing HIV-positive individuals was 48.76%. Regarding MDR species, Enterococci (77.41%) and Pseudomonas spp. (84.60%) were commonly identified in individuals with HIV infection. Our study indicates a high burden of MDR among HIV-positive individuals in Ethiopia. The Oromia region, HIV patients with multiple infections, Pseudomonas spp., and Enterococci showed the highest MDR in the subgroup analysis. Therefore, regional hospitals should implement strategies to tackle MDR such as vaccination program, appropriate use of antibiotics, and further study on the associated factors of MDR bacteria in HIV are required.

Antibiotic consumption in hospitals in humanitarian settings in Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia and South Sudan

BackgroundAntimicrobial resistance is of great global public health concern. In order to address the paucity of antibiotic consumption data and antimicrobial resistance surveillance systems in hospitals in humanitarian settings, we estimated antibiotic consumption in six hospitals with the aim of developing recommendations for improvements in antimicrobial stewardship programs.MethodsSix hospitals supported by Médecins sans Frontières were included in the study: Boost-Afghanistan, Kutupalong-Bangladesh, Baraka and Mweso-Democratic Republic of Congo, Kule-Ethiopia, and Bentiu-South Sudan. Data for 36,984 inpatients and antibiotic consumption data were collected from 2018 to 2020. Antibiotics were categorized per World Health Organization Access Watch Reserve classification. Total antibiotic consumption was measured by Defined Daily Doses (DDDs)/1000 bed-days.ResultsAverage antibiotic consumption in all hospitals was 2745 DDDs/1000 bed-days. Boost hospital had the highest antibiotic consumption (4157 DDDs/1000 bed-days) and Bentiu the lowest (1598 DDDs/1000 bed-days). In all hospitals, Access antibiotics were mostly used (69.7%), followed by Watch antibiotics (30.1%). The most consumed antibiotics were amoxicillin (23.5%), amoxicillin and clavulanic acid (14%), and metronidazole (13.2%). Across all projects, mean annual antibiotic consumption reduced by 22.3% during the study period, mainly driven by the reduction in Boost hospital in Afghanistan.ConclusionsThis was the first study to assess antibiotic consumption by DDD metric in hospitals in humanitarian settings. Antibiotic consumption in project hospitals was higher than those reported from non-humanitarian settings. Routine systematic antibiotic consumption monitoring systems should be implemented in hospitals, accompanied by prescribing audits and point-prevalence surveys, to inform about the volume and appropriateness of antibiotic use and to support antimicrobial stewardship efforts in humanitarian settings.

Measuring Temporal Trends and Patterns of Inpatient Antibiotic Use in Northwest China's Hospitals: Data from the Center for Antibacterial Surveillance, 2012-2022.

The challenge of emerging antimicrobial resistance and variation in antibiotic use across provinces in China call for knowledge on antibiotic utilization at the regional level. This study aims to evaluate the long-term trends and patterns of antibiotic usage in Xinjiang Province, the largest provincial-level division located in the northwest of China, aiming to provide evidence in enhancing provincial antimicrobial stewardship (AMS) and developing policy measures to optimize regional antimicrobial use. This was an ecological study with temporal trend analysis on inpatient antibiotic utilization, with antibiotic use data from 92 public hospitals covered by Xinjiang's Center for Antibacterial Surveillance from 2012 to 2022. Antibiotic use was measured by the number of daily defined doses per 100 patient days (DDDs/100 pds). Patterns of antibiotic use were described by Anatomical Therapeutic Chemical (ATC) subgroups and the Access, Watch, Reserve (AWaRe) classification. The Average Annual Percent Change (AAPC) of antibiotic use and the corresponding 95% confidence intervals (CIs) were calculated to describe the trend of antibiotic use over time. Joinpoint regression was performed using the Weighted Bayesian Information Criteria (WBIC) model with a parametric method. A pairwise comparison between secondary and tertiary hospitals was conducted to explore disparities in antibiotic use across hospital levels. The most commonly used antibiotics were also analyzed. The total inpatient antibiotic use in Xinjiang was 27.6 DDDs/100 patient days in 2022, with a significant decreasing trend during 2012-2022 (AAPC, -2.0%; 95% CI, -3.6% to -0.4%). The Watch group antibiotics were the most used AWaRe category, with the Access-to-Watch ratio decreasing significantly from 46.4% to 24.4% (AAPC, -6.8%; 95% CI, -8.4% to -5.1%). No significant difference was found in the trend of total antibiotic use between secondary and tertiary hospitals, but there were disparities across hospital levels in subgroups. Third-generation cephalosporins, second-generation cephalosporins, and fluoroquinolones remained the top three antibiotic class throughout the study period. The number of antibiotics accounting for 90% of the total antibiotic use decreased from 34 antibiotics in 2012 to 18 antibiotics in 2022. The decreasing trend of inpatient antibiotic use in Xinjiang's public hospitals reflects the effects of continuous AMS implementation. Patterns of antibiotic use underscore the need for further efforts on evidence-based antibiotic selection and for analyses on the appropriateness of antibiotic use.

Evaluation of Antibiotic Prescribing Practices in Surgical Departments at the University Hospital Center-Yalgado Ouedraogo, Burkina Faso

Introduction: Inappropriate use of antibiotics is one of the main causes of the emergence of antibiotic resistance in sub-Saharan Africa. To contribute to better antibiotic prescribing, the aim of this work was to evaluate prescribing in the surgery and surgical specialties department at the University Hospital Center Yalgado Ouedraogo (CHU-YO). Methods: This was a prospective cross-sectional study from December 15 to 21, 2021. Patients hospitalized in the surgical department were included. Compliance guidelines were the recommendations of the SFAR and the guide to good antibiotic prescribing in Burkina Faso. Results: A total of 162 patients were hospitalized during the study period, of whom 97 were included. The prevalence of antibiotic prescriptions was 59.9%. Curative antibiotic therapy accounted for 66% of prescriptions, while all surgical patients received antibiotic prophylaxis. The β-lactam family was prescribed in 88.5% of cases for prophylaxis and 91.3% for curative treatment. Ceftriaxone was prescribed in 71.3% of cases for prophylaxis and 44.9% for curative antibiotic therapy. Overall compliance was 22.3% for antibiotic prophylaxis and 49.3% for antibiotic therapy. Non-compliance with antibiotic prophylaxis was linked to an inappropriate choice of antibiotic for prophylaxis, and to unjustified prescribing for antibiotic therapy. Conclusion: Capacity-building for prescribers and the development of guidelines could help improve the appropriateness of antibiotic use at CHU-YO.

Prevalence of Microorganisms in UTI and Antibiotic Sensitivity Pattern among Gram Negative Isolates: A Cohort Study

Urinary tract infections (UTI) are the second most important infections followed by Respiratory tract infections. It is also important to observe the prevalence of organisms for the appropriate use of antibiotics. The study identifies Pseudomonas species and E.coli as the most predominant organisms among 180 samples. The sensitivity pattern was observed according to CLSI guidelines 2021 and most of them beta-lactam inhibitors. It is also observed that 100% of the isolates were sensitive to carbapenem and uriedopencillin group of drugs.

Behaviour change interventions addressing antibiotic treatment seeking behaviour for respiratory tract infections in primary care settings: A scoping review protocol

Objective This scoping review aims to synthesise the extent and type of evidence on behaviour change interventions which address antibiotic treatment seeking behaviour for respiratory tract infections in the primary care/community setting. Introduction Antimicrobial Resistance is recognised as a global health and economic threat by the World Health Organization and World Bank. Several lines of evidence point to patient and public demand as a key driver of inappropriate antibiotic use. Current policy initiatives acknowledge the need to prepare for the future by managing public expectations regarding antibiotics, especially for influenza-like illness and other respiratory tract infections. These initiatives emphasise the importance of designing and evaluating effective interventions that generate actionable knowledge for policy and practices related to the appropriate use of antibiotics. Behaviour change interventions, in this context, can aim to modify patients' attitudes, beliefs, and behaviours regarding antibiotics. Inclusion criteria Identified studies will describe behaviour change interventions aimed at potential patients/participants within the primary care/community setting that address patient expectations of antibiotic use for respiratory tract infections. Diagnoses for respiratory tract infections will be classified by ICD-10 criterion. Methods This scoping review will search the literature in Medline, Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and Google Scholar to explore behaviour change interventions used to reduce expectations of antibiotics for respiratory tract infections in primary care. This review will follow the Joanna Briggs Institute guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

Understanding patient demand for and use of antibiotics for upper respiratory tract infection: A qualitative application of the Necessity-Concerns Framework in Saudi Arabia.

Reducing antimicrobial resistance (AMR) is a priority for public health. Inappropriate patient demand is an important driver of unnecessary antibiotic use. To develop an effective intervention to reduce inappropriate demand for antibiotics in upper respiratory tract infections (URTIs), it is important to identify patient perceptions that influence demand for, and appropriate use of antibiotics. To identify and describe the beliefs about antibiotics necessity and concerns that patients with URTIs have, in Riyadh, Saudi Arabia. An exploratory qualitative approach was used. One-to-one, face-to-face or telephone semi-structured interviews were conducted with participants recruited using purposive sampling (based on age and gender) from primary healthcare centre in Riyadh, Saudi Arabia were conducted. Only adult patients who currently experience URTIs symptoms and agreed to participate were recruited. Recruitment for interviews continued until data saturation point was reached. The interview guide explored patients' necessity beliefs and concerns about antibiotics, AMR perceptions, and expectations from URTIs consultation. Interview transcripts were coded using QSR NVivo 12 using framework analysis informed by the Necessity-Concerns Framework to identify key motivations driving antibiotic requests and consultations. the study interviewed 32 participants (44% were male, average age was 36.84). Results identified that the patients often relate their personal need for antibiotics when encountering an URTIs symptoms to the type, severity and duration of symptoms. Patients also linked antibiotics with quicker recovery, generally expressing few concerns about antibiotics mainly because of its short duration of use. However, some conveyed their concern about frequent administration of antibiotics and effect on the body's immune system function, which may make them more prone to infections in the future. Participants varied widely in their awareness of AMR; this was associated with many misconceptions, such as confusing AMR with antibiotics efficacy and tolerance. Interestingly, the interplay between necessity beliefs and concerns was observed to influence the decision to start and stop antibiotic, potentially impacting inappropriate antibiotic demand and unnecessary use. This study highlighted important beliefs and misconceptions about antibiotics and AMR in Saudi population which can be targeted in future interventions to reduce inappropriate demand for antibiotics and optimise appropriate usage.

Appropriate use of antibiotics in outpatient pediatrics

Appropriate use of antibiotics in outpatient pediatrics

Survey of antibiotic use on outpatient at Can Tho city Otorhinolaryngology Hospital in 2023

Background: The effective use of antibiotic plays an important role in improving health and enhancing the quality of life for patients. The goal of the survey is to describe the situation of antibiotic use and to find out factors related to inappropriate antibiotic use in prescriptions of outpatient at Can tho city Otorhinolaryngology Hospital. Materials and method: A cross-sectional survey on retrospective data from 350 prescriptions of outpatient in 2023. Results: Pathology related to the ear, nose, and throat accounting for 34.3; 54.3, and 36.3% of antibiotic prescriptions, respectively. The most prescribed antibiotics belong to beta-lactam group (98.6%). The number of drugs per prescription has a significant influence on the appropriateness of antibiotic use, with prescriptions containing more than five drugs are 2.3 times more likely to be inappropriate than prescriptions containing not more than five drugs. Patients with ear disease have an inappropriate rate that is more than 14.8 times higher than patients with other diseases. Conclusion: The survey showed that the rationality in antibiotic use was influenced by the number of medications per prescription and closely related to ear disease (p &lt; 0.05). Key words: Can Tho city otorhinolaryngolory hospital; outpatient; antibiotic.

Ten-year trends of antibiotics used for patients with pneumonia at long-term care hospitals in the Republic of Korea: An analysis based on national health insurance claims data

AimTo determine the trends in the usage of antimicrobial drugs by patients with pneumonia with prescriptions from long-term care (LTC) hospitals in the Republic of Korea. MethodThis retrospective study was conducted from 2011 to 2022 using the National Health Insurance Review and Assessment Service claim data in Korea. We calculated antibiotic usage expressed as a daily defined dose (DDD) per 1000 patients per day (DID). ResultsThe number of patients with pneumonia in LTC hospitals increased by 2.7 times, from 30,000 in 2011 to 79,000 in 2022. Furthermore, antibiotic consumption per episode by patients with pneumonia in LTC hospitals increased from 17.14 DDD in 2011 to 18.11 DDD in 2022. Among the Access, Watch, and Reserve classification groups, the Watch group showed the highest usage; further, the Access group showed a decreasing trend, whereas the Watch and Reserve groups showed an increasing trend (p < 0.01). In the Watch group, the most commonly used antibiotic was J01CR05 (piperacillin and beta-lactamase inhibitor), followed in order by J01DD04 (ceftriaxone), J01MA12 (levofloxacin), and J01DH02 (meropenem). In the Reserve group, J01XB01 (colistin) and J01AA12 (tigecycline) were commonly used. ConclusionThe antibiotics prescribed for pneumonia in LTC hospitals have continuously increased the use of broad-spectrum antibiotics. Accordingly, appropriate use of antibiotics in LTC hospital settings and assessment of antibiotics used are warranted.