Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital
Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resista...
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MDPI AG
2021-05-01
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Series: | Antibiotics |
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Online Access: | https://www.mdpi.com/2079-6382/10/5/531 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nurul Adilla Hayat Jamaluddin Petrick Periyasamy Chee Lan Lau Sasheela Ponnampalavanar Pauline Siew Mei Lai Ramliza Ramli Toh Leong Tan Najma Kori Mei Kuen Yin Nur Jannah Azman Rodney James Karin Thursky Isa Naina-Mohamed |
spellingShingle |
Nurul Adilla Hayat Jamaluddin Petrick Periyasamy Chee Lan Lau Sasheela Ponnampalavanar Pauline Siew Mei Lai Ramliza Ramli Toh Leong Tan Najma Kori Mei Kuen Yin Nur Jannah Azman Rodney James Karin Thursky Isa Naina-Mohamed Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital Antibiotics antimicrobial point prevalence compliance risk prescribing |
author_facet |
Nurul Adilla Hayat Jamaluddin Petrick Periyasamy Chee Lan Lau Sasheela Ponnampalavanar Pauline Siew Mei Lai Ramliza Ramli Toh Leong Tan Najma Kori Mei Kuen Yin Nur Jannah Azman Rodney James Karin Thursky Isa Naina-Mohamed |
author_sort |
Nurul Adilla Hayat Jamaluddin |
title |
Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital |
title_short |
Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital |
title_full |
Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital |
title_fullStr |
Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital |
title_full_unstemmed |
Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital |
title_sort |
point prevalence survey of antimicrobial use in a malaysian tertiary care university hospital |
publisher |
MDPI AG |
series |
Antibiotics |
issn |
2079-6382 |
publishDate |
2021-05-01 |
description |
Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resistance in healthcare settings. Employing a comprehensive and established tool, this study investigated the trends and compliance of antimicrobial prescribing in a tertiary care teaching hospital in Malaysia to identify potential target areas for quality improvement. A point prevalence survey method following the National Antimicrobial Prescribing Survey (NAPS) was used to collect detailed data on antimicrobial prescribing and assessed a set of quality indicators associated with antimicrobial use. The paper-based survey was conducted across 37 adult wards, which included all adult in-patients on the day of the survey to form the study population. Of 478 patients surveyed, 234 (49%) patients received at least one antimicrobial agent, with 357 antimicrobial prescriptions. The highest prevalence of antimicrobial use was within the ICU (80%). Agents used were mainly amoxicillin/β-lactamase inhibitor (14.8%), piperacillin/β-lactamase inhibitor (10.6%) and third-generation cephalosporin (ceftriaxone, 9.5%). Intravenous administration was ordered in 62.7% of prescriptions. Many antimicrobials were prescribed empirically (65.5%) and commonly prescribed for pneumonia (19.6%). The indications for antimicrobials were documented in the patients’ notes for 80% of the prescriptions; however, the rate of review/stop date recorded must be improved (33.3%). One-half of surgical antimicrobial prophylaxis was administered for more than 24 h. From 280 assessable prescriptions, 141 (50.4%) were compliant with guidelines. Treating specialties, administration route, class of antimicrobial, and the number of prescriptions per patient were contributing factors associated with compliance. On multivariate analysis, administering non-oral routes of antimicrobial administration, and single antimicrobial prescription prescribed per patient was independently associated with non-compliance. NAPS can produce robust baseline information and identifying targets for improvement in antimicrobial prescribing in reference to current AMS initiatives within the tertiary care teaching hospital. The findings underscore the necessity to expand the AMS efforts towards reinforcing compliance, documentation, improving surgical prophylaxis prescribing practices, and updating local antibiotic guidelines. |
topic |
antimicrobial point prevalence compliance risk prescribing |
url |
https://www.mdpi.com/2079-6382/10/5/531 |
work_keys_str_mv |
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doaj-c9b43081cccd4d1ea7afda78021cfcf02021-05-31T23:11:53ZengMDPI AGAntibiotics2079-63822021-05-011053153110.3390/antibiotics10050531Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University HospitalNurul Adilla Hayat Jamaluddin0Petrick Periyasamy1Chee Lan Lau2Sasheela Ponnampalavanar3Pauline Siew Mei Lai4Ramliza Ramli5Toh Leong Tan6Najma Kori7Mei Kuen Yin8Nur Jannah Azman9Rodney James10Karin Thursky11Isa Naina-Mohamed12Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, MalaysiaMedical Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, MalaysiaPharmacy Department, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Primary Care Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, MalaysiaMedical Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, MalaysiaPharmacy Department, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur 56000, MalaysiaPharmacy Department, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur 56000, MalaysiaNational Centre for Antimicrobial Stewardship, Peter Doherty Research Institute for Infection and Immunity, Melbourne 3000, AustraliaNational Centre for Antimicrobial Stewardship, Peter Doherty Research Institute for Infection and Immunity, Melbourne 3000, AustraliaPharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, MalaysiaAntimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resistance in healthcare settings. Employing a comprehensive and established tool, this study investigated the trends and compliance of antimicrobial prescribing in a tertiary care teaching hospital in Malaysia to identify potential target areas for quality improvement. A point prevalence survey method following the National Antimicrobial Prescribing Survey (NAPS) was used to collect detailed data on antimicrobial prescribing and assessed a set of quality indicators associated with antimicrobial use. The paper-based survey was conducted across 37 adult wards, which included all adult in-patients on the day of the survey to form the study population. Of 478 patients surveyed, 234 (49%) patients received at least one antimicrobial agent, with 357 antimicrobial prescriptions. The highest prevalence of antimicrobial use was within the ICU (80%). Agents used were mainly amoxicillin/β-lactamase inhibitor (14.8%), piperacillin/β-lactamase inhibitor (10.6%) and third-generation cephalosporin (ceftriaxone, 9.5%). Intravenous administration was ordered in 62.7% of prescriptions. Many antimicrobials were prescribed empirically (65.5%) and commonly prescribed for pneumonia (19.6%). The indications for antimicrobials were documented in the patients’ notes for 80% of the prescriptions; however, the rate of review/stop date recorded must be improved (33.3%). One-half of surgical antimicrobial prophylaxis was administered for more than 24 h. From 280 assessable prescriptions, 141 (50.4%) were compliant with guidelines. Treating specialties, administration route, class of antimicrobial, and the number of prescriptions per patient were contributing factors associated with compliance. On multivariate analysis, administering non-oral routes of antimicrobial administration, and single antimicrobial prescription prescribed per patient was independently associated with non-compliance. NAPS can produce robust baseline information and identifying targets for improvement in antimicrobial prescribing in reference to current AMS initiatives within the tertiary care teaching hospital. The findings underscore the necessity to expand the AMS efforts towards reinforcing compliance, documentation, improving surgical prophylaxis prescribing practices, and updating local antibiotic guidelines.https://www.mdpi.com/2079-6382/10/5/531antimicrobialpoint prevalencecomplianceriskprescribing |