Antimicrobial prescribing in referral hospitals in Timor-Leste: results of the first two national point prevalence surveys, 2020-21.

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-08-01 DOI:10.1093/jacamr/dlae123
Guilherme Ximenes, Sajal K Saha, Helio Guterres, Adriano Vieira, Lisa Harris, Michelle Mahony, Agata Dos Santos, Lucia Toto, Elfiana Amaral, Jessie C Spargo, Sze Yen Tay, Salvador Amaral, Karen Champlin, Anthony D K Draper, Joshua R Francis, Jennifer Yan, Sarah A Lynar
{"title":"Antimicrobial prescribing in referral hospitals in Timor-Leste: results of the first two national point prevalence surveys, 2020-21.","authors":"Guilherme Ximenes, Sajal K Saha, Helio Guterres, Adriano Vieira, Lisa Harris, Michelle Mahony, Agata Dos Santos, Lucia Toto, Elfiana Amaral, Jessie C Spargo, Sze Yen Tay, Salvador Amaral, Karen Champlin, Anthony D K Draper, Joshua R Francis, Jennifer Yan, Sarah A Lynar","doi":"10.1093/jacamr/dlae123","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste.</p><p><strong>Methods: </strong>In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients.</p><p><strong>Results: </strong>In 2020, 291/394 (73.9%) surveyed patients had been prescribed antimicrobials, compared with 260/403 (64.5%) in 2021 (<i>P</i> = 0.004). Most (309/551; 56.1%) were prescribed one antimicrobial, and 179/551 (32.5%) were prescribed two. The most commonly prescribed antibiotics were ceftriaxone (38.5% in 2020, 41.5% in 2021) and ampicillin (35.7% in 2020, 32.3% in 2021), followed by gentamicin, metronidazole and cloxacillin. Reserve antibiotics like meropenem and vancomycin were minimally used. Of all antimicrobial prescriptions, 70.8% were deemed appropriate in 2020 and 69.1% in 2021. Antimicrobial prescriptions for surgical and post-partum prophylaxis were frequently deemed inappropriate [37/50 (74.0%) and 39/44 (88.6%) prescriptions, respectively].</p><p><strong>Conclusions: </strong>Most patients admitted to hospital in Timor-Leste are prescribed antimicrobials, and approximately one-third of these prescriptions are inappropriate. However, this was in the context of limited local guideline availability at the time of surveys and limited microbiological culture capacity outside of the capital, Dili. Improved microbiological guidance, iterative guideline revisions based on local antimicrobial resistance (AMR) surveillance data, and enhanced stewardship activities including further point prevalence studies, could improve antimicrobial use, optimize patient outcomes and reduce AMR in Timor-Leste.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae123"},"PeriodicalIF":3.7000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293431/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAC-Antimicrobial Resistance","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jacamr/dlae123","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste.

Methods: In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients.

Results: In 2020, 291/394 (73.9%) surveyed patients had been prescribed antimicrobials, compared with 260/403 (64.5%) in 2021 (P = 0.004). Most (309/551; 56.1%) were prescribed one antimicrobial, and 179/551 (32.5%) were prescribed two. The most commonly prescribed antibiotics were ceftriaxone (38.5% in 2020, 41.5% in 2021) and ampicillin (35.7% in 2020, 32.3% in 2021), followed by gentamicin, metronidazole and cloxacillin. Reserve antibiotics like meropenem and vancomycin were minimally used. Of all antimicrobial prescriptions, 70.8% were deemed appropriate in 2020 and 69.1% in 2021. Antimicrobial prescriptions for surgical and post-partum prophylaxis were frequently deemed inappropriate [37/50 (74.0%) and 39/44 (88.6%) prescriptions, respectively].

Conclusions: Most patients admitted to hospital in Timor-Leste are prescribed antimicrobials, and approximately one-third of these prescriptions are inappropriate. However, this was in the context of limited local guideline availability at the time of surveys and limited microbiological culture capacity outside of the capital, Dili. Improved microbiological guidance, iterative guideline revisions based on local antimicrobial resistance (AMR) surveillance data, and enhanced stewardship activities including further point prevalence studies, could improve antimicrobial use, optimize patient outcomes and reduce AMR in Timor-Leste.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
东帝汶转诊医院的抗菌药物处方:2020-21 年前两次全国点流行率调查结果。
目的:描述东帝汶医院住院病人的抗菌药物使用情况(AMU):描述东帝汶医院住院病人的抗菌药物使用情况(AMU):2020年和2021年,我们在东帝汶所有六家医院(一家国立医院和五家市立医院)开展了抗菌药物处方点流行率调查,以描述入院患者的抗菌药物使用情况和适当性:2020年,291/394(73.9%)名接受调查的患者开具了抗菌药物处方,而2021年为260/403(64.5%)人(P = 0.004)。大多数患者(309/551;56.1%)处方了一种抗菌药,179/551(32.5%)处方了两种抗菌药。最常处方的抗生素是头孢曲松(2020 年为 38.5%,2021 年为 41.5%)和氨苄西林(2020 年为 35.7%,2021 年为 32.3%),其次是庆大霉素、甲硝唑和氯唑西林。美罗培南和万古霉素等备用抗生素的使用率极低。在所有抗菌药物处方中,2020 年有 70.8%被认为是适当的,2021 年为 69.1%。用于手术和产后预防的抗菌药物处方经常被认为是不适当的[分别为 37/50 (74.0%) 和 39/44 (88.6%)]:结论:在东帝汶,大多数住院病人都会被开具抗菌药物处方,其中约三分之一的处方是不恰当的。然而,在调查时,当地提供的指南有限,首都帝力以外的微生物培养能力也有限。在东帝汶,根据当地抗菌药物耐药性(AMR)监测数据改进微生物指导、反复修订指导原则以及加强监管活动(包括进一步的点流行率研究),可以改善抗菌药物的使用、优化患者的治疗效果并减少 AMR。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.30
自引率
0.00%
发文量
0
审稿时长
16 weeks
期刊最新文献
Nursing home nurses' opinion profiles on the potential evolution of their role in antimicrobial stewardship and associated factors: a national cross-sectional study in France. Clinical pharmacist-led antifungal drug utilization reviews in cancer care hospital: a prospective audit and feedback. State of the art of real-life concentration monitoring of rifampicin and its implementation contextualized in resource-limited settings: the Tanzanian case. Capturing the complexity of veterinarians' antibiotic prescribing practices in the livestock sector: a meta-ethnography across contexts: Veterinarians' antibiotic prescribing in different contexts. Development of a PCR assay for rapid and accurate detection of an emerging vanB Enterococcus faecium clone in the Capital Region of Denmark.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1