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

Zikria Saleem, Mohamed Azmi Hassali, Furqan Khurshid Hashmi, Brian Godman, Omar Akhlaq Bhutta

Research output: Contribution to journalArticle

Abstract

Background: 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. Method: 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. Results: 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%). Conclusion: 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.
LanguageEnglish
Pages149-154
Number of pages6
JournalHospital Practice
Volume47
Issue number3
Early online date10 Jun 2019
DOIs
Publication statusPublished - 27 Jun 2019

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Cancer Care Facilities
meropenem
Pakistan
Bed Occupancy
Piperacillin
Acyclovir
Ceftriaxone
Fluconazole
Immunocompromised Host
Amphotericin B
Enzyme Inhibitors
Vancomycin
Centers for Disease Control and Prevention (U.S.)
Respiratory Tract Infections
Antiviral Agents
Intensive Care Units
Sepsis
Fever
Pediatrics
Surveys and Questionnaires

Keywords

  • point prevalence study
  • cancer
  • antimicrobial use
  • Pakistan
  • antimicrobial resistance

Cite this

Saleem, Zikria ; Hassali, Mohamed Azmi ; Hashmi, Furqan Khurshid ; Godman, Brian ; Bhutta, Omar Akhlaq. / A repeated point prevalence survey of antimicrobial use in specialized cancer care hospital of Pakistan : findings and implications. In: Hospital Practice. 2019 ; Vol. 47, No. 3. pp. 149-154.
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A repeated point prevalence survey of antimicrobial use in specialized cancer care hospital of Pakistan : findings and implications. / Saleem, Zikria ; Hassali, Mohamed Azmi; Hashmi, Furqan Khurshid; Godman, Brian; Bhutta, Omar Akhlaq.

In: Hospital Practice, Vol. 47, No. 3, 27.06.2019, p. 149-154.

Research output: Contribution to journalArticle

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