Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital
Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resista...
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my.um.eprints.345252022-09-14T07:31:23Z http://eprints.um.edu.my/34525/ Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital Jamaluddin, Nurul Adilla Hayat Periyasamy, Petrick Lau, Chee Lan Ponnampalavanar, Sasheela Sri La Sri Lai, Pauline Siew Mei Ramli, Ramliza Tan, Toh Leong Kori, Najma Yin, Mei Kuen Azman, Nur Jannah James, Rodney Thursky, Karin Naina-Mohamed, Isa R Medicine RB Pathology Theories of disease. Etiology. Pathogenesis RS Pharmacy and materia medica Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resistance in healthcare settings. Employing a comprehensive and established tool, this study investigated the trends and compliance of antimicrobial prescribing in a tertiary care teaching hospital in Malaysia to identify potential target areas for quality improvement. A point prevalence survey method following the National Antimicrobial Prescribing Survey (NAPS) was used to collect detailed data on antimicrobial prescribing and assessed a set of quality indicators associated with antimicrobial use. The paper-based survey was conducted across 37 adult wards, which included all adult in-patients on the day of the survey to form the study population. Of 478 patients surveyed, 234 (49%) patients received at least one antimicrobial agent, with 357 antimicrobial prescriptions. The highest prevalence of antimicrobial use was within the ICU (80%). Agents used were mainly amoxicillin/beta-lactamase inhibitor (14.8%), piperacillin/beta-lactamase inhibitor (10.6%) and third-generation cephalosporin (ceftriaxone, 9.5%). Intravenous administration was ordered in 62.7% of prescriptions. Many antimicrobials were prescribed empirically (65.5%) and commonly prescribed for pneumonia (19.6%). The indications for antimicrobials were documented in the patients' notes for 80% of the prescriptions; however, the rate of review/stop date recorded must be improved (33.3%). One-half of surgical antimicrobial prophylaxis was administered for more than 24 h. From 280 assessable prescriptions, 141 (50.4%) were compliant with guidelines. Treating specialties, administration route, class of antimicrobial, and the number of prescriptions per patient were contributing factors associated with compliance. On multivariate analysis, administering non-oral routes of antimicrobial administration, and single antimicrobial prescription prescribed per patient was independently associated with non-compliance. NAPS can produce robust baseline information and identifying targets for improvement in antimicrobial prescribing in reference to current AMS initiatives within the tertiary care teaching hospital. The findings underscore the necessity to expand the AMS efforts towards reinforcing compliance, documentation, improving surgical prophylaxis prescribing practices, and updating local antibiotic guidelines. MDPI 2021-05 Article PeerReviewed Jamaluddin, Nurul Adilla Hayat and Periyasamy, Petrick and Lau, Chee Lan and Ponnampalavanar, Sasheela Sri La Sri and Lai, Pauline Siew Mei and Ramli, Ramliza and Tan, Toh Leong and Kori, Najma and Yin, Mei Kuen and Azman, Nur Jannah and James, Rodney and Thursky, Karin and Naina-Mohamed, Isa (2021) Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital. Antibiotics-Basel, 10 (5). ISSN 2079-6382, DOI https://doi.org/10.3390/antibiotics10050531 <https://doi.org/10.3390/antibiotics10050531>. 10.3390/antibiotics10050531 |
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R Medicine RB Pathology Theories of disease. Etiology. Pathogenesis RS Pharmacy and materia medica Jamaluddin, Nurul Adilla Hayat Periyasamy, Petrick Lau, Chee Lan Ponnampalavanar, Sasheela Sri La Sri Lai, Pauline Siew Mei Ramli, Ramliza Tan, Toh Leong Kori, Najma Yin, Mei Kuen Azman, Nur Jannah James, Rodney Thursky, Karin Naina-Mohamed, Isa Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital |
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Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resistance in healthcare settings. Employing a comprehensive and established tool, this study investigated the trends and compliance of antimicrobial prescribing in a tertiary care teaching hospital in Malaysia to identify potential target areas for quality improvement. A point prevalence survey method following the National Antimicrobial Prescribing Survey (NAPS) was used to collect detailed data on antimicrobial prescribing and assessed a set of quality indicators associated with antimicrobial use. The paper-based survey was conducted across 37 adult wards, which included all adult in-patients on the day of the survey to form the study population. Of 478 patients surveyed, 234 (49%) patients received at least one antimicrobial agent, with 357 antimicrobial prescriptions. The highest prevalence of antimicrobial use was within the ICU (80%). Agents used were mainly amoxicillin/beta-lactamase inhibitor (14.8%), piperacillin/beta-lactamase inhibitor (10.6%) and third-generation cephalosporin (ceftriaxone, 9.5%). Intravenous administration was ordered in 62.7% of prescriptions. Many antimicrobials were prescribed empirically (65.5%) and commonly prescribed for pneumonia (19.6%). The indications for antimicrobials were documented in the patients' notes for 80% of the prescriptions; however, the rate of review/stop date recorded must be improved (33.3%). One-half of surgical antimicrobial prophylaxis was administered for more than 24 h. From 280 assessable prescriptions, 141 (50.4%) were compliant with guidelines. Treating specialties, administration route, class of antimicrobial, and the number of prescriptions per patient were contributing factors associated with compliance. On multivariate analysis, administering non-oral routes of antimicrobial administration, and single antimicrobial prescription prescribed per patient was independently associated with non-compliance. NAPS can produce robust baseline information and identifying targets for improvement in antimicrobial prescribing in reference to current AMS initiatives within the tertiary care teaching hospital. The findings underscore the necessity to expand the AMS efforts towards reinforcing compliance, documentation, improving surgical prophylaxis prescribing practices, and updating local antibiotic guidelines. |
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Article |
author |
Jamaluddin, Nurul Adilla Hayat Periyasamy, Petrick Lau, Chee Lan Ponnampalavanar, Sasheela Sri La Sri Lai, Pauline Siew Mei Ramli, Ramliza Tan, Toh Leong Kori, Najma Yin, Mei Kuen Azman, Nur Jannah James, Rodney Thursky, Karin Naina-Mohamed, Isa |
author_facet |
Jamaluddin, Nurul Adilla Hayat Periyasamy, Petrick Lau, Chee Lan Ponnampalavanar, Sasheela Sri La Sri Lai, Pauline Siew Mei Ramli, Ramliza Tan, Toh Leong Kori, Najma Yin, Mei Kuen Azman, Nur Jannah James, Rodney Thursky, Karin Naina-Mohamed, Isa |
author_sort |
Jamaluddin, Nurul Adilla Hayat |
title |
Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital |
title_short |
Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital |
title_full |
Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital |
title_fullStr |
Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital |
title_full_unstemmed |
Point prevalence survey of antimicrobial use in a Malaysian tertiary care university hospital |
title_sort |
point prevalence survey of antimicrobial use in a malaysian tertiary care university hospital |
publisher |
MDPI |
publishDate |
2021 |
url |
http://eprints.um.edu.my/34525/ |
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1744649184618741760 |
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13.18916 |