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A multicenter point prevalence survey of antibiotic use in Punjab,Pakistan: findings and implications |
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| Authors: | Zikria Saleem Mohamed Azmi Hassali Ann Versporten Brian Godman Furqan Khurshid Hashmi Herman Goossens |
| Affiliation: | 1. School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia;2. Department of Pharmacy Practice, Rashid Latif College of Pharmacy, Pakistan;3. Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium;4. Department of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden;5. Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK;6. Health Economics Centre, University of Liverpool Management School, Liverpool, UK;7. Department of Pharmacy Practice, University College of Pharmacy, University of the Punjab, Lahore, Pakistan |
| 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. |
| Keywords: | Point prevalence survey antimicrobial prescribing antimicrobial resistance hospitals Pakistan |