A repeated point prevalence survey of antimicrobial use in specialized cancer care hospital of Pakistan: findings and implications.

Saleem, Zikria ORCID: 0000-0003-3202-6347, Hassali, Mohamed Azmi ORCID: 0000-0001-9575-403X, Hashmi, Furqan Khurshid, Godman, Brian ORCID: 0000-0001-6539-6972 and Bhutta, Omar Akhlaq (2019) A repeated point prevalence survey of antimicrobial use in specialized cancer care hospital of Pakistan: findings and implications. Hospital practice (1995), 47 (3). pp. 149-154.

Text Accepted for publication Saleem et al.docx - Author Accepted Manuscript Download (99kB)

Abstract

<b>Background</b>: The extensive use of broad-spectrum antimicrobials in immunocompromised patients is inevitable in situations where culture and sensitivity testing is challenging. However, their overuse leads to an increase in antimicrobial resistance (AMR), which is a growing concern. <b>Method</b>: A repeated point prevalence survey (PPS) was conducted to assess the pattern of antimicrobial prescribing in a specialized cancer care hospital in Pakistan using the methodology employed by the European Centre of Disease Prevention and Control. <b>Results</b>: Out of 313 hospitalized patients, 156 (49.8%) were prescribed one or more antimicrobials, 82 (50.9) in 2017 and 74 (48.7) in 2018. The average bed occupancy in the hospital was 80.3%. Fever in neutropenic patients (20.2%), lower respiratory tract infections (17.8%), and sepsis (14.9%) were the three most common clinical indications. The total number of prescribed antimicrobials was 242, of whom, 41 (16.9%) were given orally and 201 (83.1%) were given parenterally. The most commonly used antimicrobials were piperacillin plus enzyme inhibitor (31.8%), meropenem (7.9%), ceftriaxone (6.2%) and vancomycin (6.2%). Of the total prescribed antimicrobials, 42 (17.3%) antimicrobials were used in surgical departments, 89 (36.8) in adult medical departments, 73 (30.1%) in pediatric medical departments and 38 (15.7) in the intensive care unit (ICU). In addition to these antibacterials, there was relatively high use of antivirals (acyclovir; 4.1%) and antifungals (fluconazole; 3.7%, amphotericin B; 2.9%). <b>Conclusion</b>: The study concluded that broad-spectrum antimicrobial usage in cancer hospitals in Pakistan is high, which can be a risk factor for the emergence of AMR. Repeated PPS is a fruitful way to maintain a focus on inappropriate antimicrobial use and develop pertinent intervention programs targeteing specific issues to improve future use.

Item Type:	Article
Uncontrolled Keywords:	Humans, Neoplasms, Anti-Infective Agents, Prevalence, Cross-Sectional Studies, Immunocompromised Host, Cancer Care Facilities, Pakistan, Surveys and Questionnaires, Practice Patterns, Physicians', Antimicrobial Stewardship
Depositing User:	Symplectic Admin
Date Deposited:	08 Jul 2019 15:06
Last Modified:	19 Jan 2023 00:38
DOI:	10.1080/21548331.2019.1628614
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3048882