Point prevalence survey of antibiotic use in hospitals in Latin American countries

• Published in: Journal of antimicrobial chemotherapy Vol. 77; no. 3; pp. 807 - 815
• Main Authors: Levy Hara, Gabriel, Rojas-Cortés, Robin, Molina León, Helvert Felipe, Dreser Mansilla, Anahí, Alfonso Orta, Ismary, Rizo-Amezquita, José Noe, Santos Herrera, René Guillermo, Mendoza de Ayala, Silvia, Arce Villalobos, Marlen, Mantilla Ponte, Hilda, Davila, Ever, Aguilar, Gloria, Porrás, Analía, Ramón-Pardo, Pilar, Castro, José Luis
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 23-02-2022
• Subjects: Anti-Bacterial Agents - therapeutic use; Cross Infection - epidemiology; Hospitals; Humans; Latin America - epidemiology; Original Research; Prevalence; Latin America
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkab459

Abstract
Background
Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals.
Methods
An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCap©) through a mobile device was used for data collection.
Results
Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6% received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3% of cases.
Conclusions
Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America.