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A Point Prevalence Survey of Antimicrobial Prescribing in a South Indian Tertiary Hospital; Using Global PPS Tool


Affiliations
1 Department of Pharmacy, Annamalai University, Annamalai Nagar, Chidambaram - 608002, Tamil Nadu, India
2 Deparment of Pharmacy, Sims College of Pharmacy, Mangaldas Nagar, Guntur - 522001, India
 

Identifying the targets for improving antimicrobial prescription and development of antimicrobial stewardship interventions can better serve to combat the situation of antimicrobial resistance. The primary objective was to determine the prevalence of antimicrobial use at tertiary care teaching hospital with both acute and long-term care patients. A periodical point prevalence survey was done in a tertiary care hospital of South India during 2019 using manual and webbased GLOBAL-PPS tool. Of 945 patients eligible for the study, 645 (69.5 %) received at least one antibiotic, with highest rates in the adult surgical ward and pediatrics. Of 645 therapeutic antibiotic prescriptions, 58.6% prescriptions have an infectious indication of them, 62.6% are community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. The prevalence of antibiotic use is very high, and our study evidence that the country needs a robust antimicrobial stewardship intervention program.


Keywords

Antimicrobial Prescribing, Antimicrobial Resistance, Antimicrobial Stewardship, GLOBAL-PPS, India
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  • Alharbi SA, Wainwright M, Alahmadi TA, Salleeh HB, Faden AA, Chinnathambi A. What if Fleming had not discovered penicillin? Saudi J. Biol. Sci. 1 Sep 2014; 21(4): 289–93. https://doi.org/10.1016/j.sjbs.2013.12.007

  • Laxminarayan R, Matsoso P, Pant S, Brower C, Røttingen JA, Klugman K, Davies S. Access to effective antimicrobials: a worldwide challenge. The Lancet. 9 Jan 2016; 387(10014): 168–75. https://doi.org/10.1016/S0140-6736(15)00474-2

  • Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, Laxminarayan R. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. The Lancet infectious diseases. 1 Aug 2014; 14(8):742–50. https://doi.org/10.1016/S14733099(14)70780-7

  • National centre for disease control. National programme on AMR containment. Assed on 20-08-2020. https://ncdc.gov.in/index1.php?lang=1&level=2&sublinkid=384&lid=344.

  • Travasso C. India draws a red line under antibiotic misuse. BMJ 2016; 352: i1202. https://doi.org/10.1136/bmj. i1202

  • World Health Organization. WHO report on surveillance of antibiotic consumption: 2016-2018 early implementation. Assed on 2-11-2020. https://www.who.int/medicines/ areas/rational_use/oms-amr-amc-report-2016-2018/en/ (2018).

  • Vadivoo NS, Usha B, Sudha K. Study to assess quality of antimicrobial use by point prevalence survey at a tertiary care centre. Indian J Microbiol Res. 2019; 6(3):245–252. https://doi.org/10.18231/j.ijmr.2019.054

  • Ravi N, Laha A, Hmar L, Chatterjee S, Goswami J, Goel G, Dhar K, Ghosh T, Chatterjee S, Datta SS, Bhattacharya S. Exploring the prescribing behaviours and the mind of antibiotic prescribers is critical for a successful antibiotic stewardship programme: Results of a survey from Eastern India. Indian J. Med. Microbiol. 1 Apr 2017; 35(2):299. https://doi.org/10.4103/ijmm.IJMM_17_133

  • Gandra S, Alvarez-Uria G, Murki S, Singh SK, Kanithi R, Jinka DR, Chikkappa AK, Subramanian S, Sharma A, Dharmapalan D, Kandraju H. Point prevalence surveys of antimicrobial use among eight neonatal intensive care units in India: 2016. Int J Infect Dis. 2018 Jun 1; 71:20–4. https://doi.org/10.1016/j.ijid.2018.03.017

  • Sharma M, Damlin A, Pathak A, Lundborg CS. Antibiotic prescribing among pediatric inpatients with potential infections in two private sector hospitals in Central India. PLoS One. 5 Nov 2015; 10(11):e0142317. https://doi.org/10.1371/journal.pone.0142317

  • Singh SK, Sengupta S, Antony R, Bhattacharya S, Mukhopadhyay C, Ramasubramanian V, Sharma A, Sahu S, Nirkhiwale S, Gupta S, Rohit A. Variations in antibiotic use across India: multi-centre study through Global Point Prevalence survey. J. Hosp. Infect. 1 Nov 2019; 103(3): 280– 3. https://doi.org/10.1016/j.jhin.2019.05.014

  • Singh S, Jose T, Versporten A, Sengupta S, Fini P, Sharland M, Kumar RK, Goossens H. A point prevalence surveillance study from pediatric and neonatal specialty hospitals in India. Pediatr Infect Dis J. 1 Jan 2014; 9(3):151–5. https://doi.org/10.3233/JPI-140429

  • World Health Organization. In: and others, editor. WHO methodology for point prevalence survey on antibiotic use in hospitals, version 1.1. World Health Organization. Assessed on 2-11-2020. http://www.who.int/iris/handle/10665/280063.

  • World Health Organization. How to investigate antimicrobial use in hospitals: selected indicators. 2012. Assed on 1-11-2020. http://apps.who.int/medicinedocs/documents/s21031en/s21031en.pdf.

  • Raosoft. Sample size calculator. Assed on 1-11-2020. http:// www.raosoft.com/samplesize.html.

  • World Health Organization (1993) How to investigate drug use in health facilities: Selected drug use indicators. Geneva, World Health Organization 1993. WHO/DAP 1: 1–87. http://www.global-pps.com/documents

  • WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2017. Assessed on 1-112020. https://www.whocc.no/atc_ddd_index/.

  • Versporten A, Zarb P, Caniaux I, Gros MF, Drapier N, Miller M, Jarlier V, Nathwani D, Goossens H, Koraqi A, Hoxha I. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey. The Lancet Global Health. 1 Jun 2018; 6(6):e619–29.

  • Robert J, Péan Y, Varon E, Bru JP, Bedos JP, Bertrand X, Lepape A, Stahl JP, Gauzit R. Point prevalence survey of antibiotic use in French hospitals in 2009. J. Antimicrob. Chemother. 1 Apr 2012; 67(4):1020–6. https://doi.org/10.1093/jac/dkr571

  • Skoog G, Struwe J, Cars O, Hanberger H, Odenholt I, Prag M, Skärlund K, Ulleryd P, Erntell M. Repeated nationwide point-prevalence surveys of antimicrobial use in Swedish hospitals: data for actions 2003–2010. Eurosurveillance. 23 Jun 2016; 21(25):30264. https://doi.org/10.2807/15607917.ES.2016.21.25.30264

  • Usluer G, Ozgunes I, Leblebicioglu H. A multicenter point-prevalence study: antimicrobial prescription frequencies in hospitalized patients in Turkey. Annals of clinical Microbiology and Antimicrobials. Dec 2005; 4(1): 1–5. https://doi.org/10.1186/1476-0711-4-16

  • Elhajji FD, Al-Taani GM, Anani L, Al-Masri S, Abdalaziz H, Su’ad H, Al Bawab AQ, Scott M, Farren D, Gilmore F, Versporten A. Comparative point prevalence survey of antimicrobial consumption between a hospital in Northern Ireland and a hospital in Jordan. BMC health services research. 1 Dec 2018; 18(1):849. https://doi.org/10.1186/s12913-018-3656-y

  • Porto AP, Goossens H, Versporten A, Costa SF, Brazilian Global-PPS Working Group. Global point prevalence survey of antimicrobial consumption in Brazilian hospitals. J. Hosp. Infect. 1 Feb 2020; 104(2):165–71. https://doi.org/10.1016/j.jhin.2019.10.016

  • Oduyebo OO, Olayinka AT, Iregbu KC, Versporten A, Goossens H, NwajiobiPrincewill PI, et al. A point prevalence survey of antimicrobial prescribing in four Nigerian tertiary hospitals. Ann Trop Pathol. 2017; 8(1):42–6. https://doi.org/10.4103/atp.atp_38_17

  • Zingg W, Metsini A, Gardiol C, Balmelli C, Behnke M, Troillet N, Widmer A, Pittet D. Antimicrobial use in acute care hospitals: national point prevalence survey on healthcare-associated infections and antimicrobial use, Switzerland, 2017. Eurosurveillance. 15 Aug 2019; 24(33):1900015. https://doi.org/10.2807/1560-7917.ES.2019.24.33.1900015

  • Lee C, Walker SA, Daneman N, Elligsen M, Palmay L, Coburn B, Simor A. Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital. Journal of epidemiology and global health. 1 Jun 2015; 5(2): 143–50. https://doi.org/10.1016/j.jegh.2014.06.003

  • Talaat M, Saied T, Kandeel A, El-Ata GA, El-Kholy A, Hafez S, Osman A, Razik MA, Ismail G, El-Masry S, Galal R. A point prevalence survey of antibiotic use in 18 hospitals in Egypt. Antibiotics. Sep 2014; 3(3):450–60. https://doi.org/10.3390/antibiotics3030450

  • Al Matar M, Enani M, Binsaleh G, Roushdy H, Alokaili D, Al Bannai A, Khidir Y, Al-Abdely H. Point prevalence survey of antibiotic use in 26 Saudi hospitals in 2016. J. Infect. Public Health. 1 Jan 2019; 12(1):77–82. https://doi.org/10.1016/j.jiph.2018.09.003

  • Xie DS, Xiang LL, Li R, Hu Q, Luo QQ, Xiong W. A multicenter point-prevalence survey of antibiotic use in 13 Chinese hospitals. J. Infect. Public Health. 1 Jan 2015; 8(1): 55–61. https://doi.org/10.1016/j.jiph.2014.07.001

  • National treatment guidelines for antimicrobial use in infectious disease. 2016. Assessed on 01-11-2020. https:// ncdc.gov.in/WriteReadData/l892s/File622.pdf

  • Bebell LM, Muiru AN. Antibiotic use and emerging resistance: how can resource-limited countries turn the tide? Global heart. 1 Sep 2014; 9(3):347–58. https://doi.org/10.1016/j.gheart.2014.08.009

  • Absolutereports.com. Global (North America, Europe and Asia-Pacific, South America, Middle East and Africa) Procalcitonin (CAS 56645-65-9) Market 2017 Forecast to 2022. Pune; 2017. Available from: https://www.absolutereports.com/11101460 [Last accessed on 2017 Sep 25].


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  • A Point Prevalence Survey of Antimicrobial Prescribing in a South Indian Tertiary Hospital; Using Global PPS Tool

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Authors

Vineela Chadalavada
Department of Pharmacy, Annamalai University, Annamalai Nagar, Chidambaram - 608002, Tamil Nadu, India
Manohar Babu S.
Deparment of Pharmacy, Sims College of Pharmacy, Mangaldas Nagar, Guntur - 522001, India
Balamurugan K.
Department of Pharmacy, Annamalai University, Annamalai Nagar, Chidambaram - 608002, Tamil Nadu, India

Abstract


Identifying the targets for improving antimicrobial prescription and development of antimicrobial stewardship interventions can better serve to combat the situation of antimicrobial resistance. The primary objective was to determine the prevalence of antimicrobial use at tertiary care teaching hospital with both acute and long-term care patients. A periodical point prevalence survey was done in a tertiary care hospital of South India during 2019 using manual and webbased GLOBAL-PPS tool. Of 945 patients eligible for the study, 645 (69.5 %) received at least one antibiotic, with highest rates in the adult surgical ward and pediatrics. Of 645 therapeutic antibiotic prescriptions, 58.6% prescriptions have an infectious indication of them, 62.6% are community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. The prevalence of antibiotic use is very high, and our study evidence that the country needs a robust antimicrobial stewardship intervention program.


Keywords


Antimicrobial Prescribing, Antimicrobial Resistance, Antimicrobial Stewardship, GLOBAL-PPS, India

References





DOI: https://doi.org/10.18311/ajprhc%2F2021%2F26368