A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

Zikria Saleem*, Mohamed Azmi Hassali, Ann Versporten, Brian Godman, Furqan Khurshid Hashmi, Herman Goossens, Fahad Saleem

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

Abstract

Objectives: In line with the recent global action plan for antimicrobial resistance, this is the first time such a comprehensive antimicrobial point prevalence survey has been undertaken in Pakistan, the sixth most populous country. Methods: This point prevalence survey (PPS) was conducted in 13 hospitals among 7 different cities of Pakistan. The survey included all inpatients receiving an antibiotic on the day of PPS. A web-based application was used for data entry, validation, and reporting as designed by the University of Antwerp (www.global-pps.com). Results: Out of 1954 patients, 1516 (77.6%) were treated with antibiotics. The top three most reported indications for antibiotic use were prophylaxis for obstetrics or gynaecological indications (16.5%), gastrointestinal indications (12.6%) and lower respiratory tract infections (12.0%). The top three most commonly prescribed antibiotics were ceftriaxone (35.0%), metronidazole (16.0%) and ciprofloxacin (6.0%). Out of the total indications, 34.2% of antibiotics were prescribed for community-acquired infections (CAI), 5.9% for healthcare-associated infections (HAI), and 57.4% for either surgical or medical prophylaxis. Of the total use for surgical prophylaxis, 97.4% of antibiotics were given for more than one day. Conclusions: Unnecessary prophylactic antibiotic use is extremely high, and broad-spectrum prescribing is common among hospitals in Pakistan. There is an urgent need to work on the  national action plan of Pakistan on antibiotic resistance to address this.

Original languageEnglish
Pages (from-to)285-293
Number of pages9
JournalExpert Review of Anti-Infective Therapy
Volume17
Issue number4
DOIs
Publication statusPublished - 3 Apr 2019
Externally publishedYes

Keywords

  • Pakistan
  • Point prevalence survey
  • antimicrobial prescribing
  • antimicrobial resistance
  • hospitals

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