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1. Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries

Author

Pauwels, Ines, Versporten, Ann, Drapier, Nico, Vlieghe, Erika, Goossens, Herman, Koraqi, Andi, Hoxha, Iris, Tafaj, Silva, Cornistein, Wanda, Quiros, Rodolfo, Hojman, Martin, Ghazaryan, Lilit, Horne, Kylie, Cairns, Kelly, Doukas, Fiona, Gottlieb, Thomas, Sermijn, Erica, Verhamme, Katia, Brands, Christiane, Van Herendael, Bruno, Filippin, Lorenzo, Vandewal, Wouter, Konopnicki, Deborah, Maillart, Evelyne, Teixeira Lopes, Liliana, Papin, Pauline, Smits, Ilse, Jansens, Hilde, Bartholomeus, Sofie, Van den Abeele, Anne-Marie, Steyaert, Sophia, Piette, Anne, Buyle, Franky, Cartuyvels, Reinoud, Jonckheere, Stijn, Wybo, Ingrid, Vanneste, Lorenz, Mathieu, Delphine, Firre, Eric, Westelinck, Veerle, Gadisseux, Philippe, Dugernier, Thierry, Bafort, Kristof, Gonissen, Viviane, Vanderper, Vanessa, Gabriels, Patrick, Weekers, Frank, Michel, Philippe, Van Liedekerke, Ann, Costers, Michiel, Catry, Boudewijn, Dedeic-Ljubovic, Amela, Gales, Ana C., Matos Porto, Ana Paula, Figueiredo Costa, Silvia, Keuleyan, Emma, Beidi, Apollinaire, Cissohko, Youssouph, Blakwe, Habsatou, Batchaya Basile, Ngassa, German, Greg J., Lutes, Sarah, Boswell, Jennifer, Mertz, Dominik, Nguyen, Tuyen, MacLaggan, Timothy, Landry, Daniel, Ang, Anita, Thirion, Daniel J.G., Frenette, Charles, Émond, Yannick, Roberts, Jacqueline, Chang, Sandra, Kosar, Justin, Valiquette, Louis, Dutrisac, Ginette, Afra, Kevin, McGeer, Allison, Carrier, Marie, Grant, Jennifer, Labarca, Jaime, Carvajal, Camila, Lin, HongYi, Wang, Qiang, Yang, Jing, Yang, Wenjie, Cortes, Jorge A., Villalobos-Vindas, Juan, Ramírez-Valverde, Carlos, Horvatic, Jasminka, Pristas, Irina, Paphitou, Niki, Rummukainen, Maija-Liisa, Froissart, Antoine, Vanhems, Philippe, Pagava, Karaman, Korinteli, Irma, Brandt, Tobias, Gaertner, Johannes, Enimil, Anthony, Roilides, Emmanuel, Hajdú, Edit, Sengupta, Sharmila, Singh, Sanjeev, Patil, Priyanka, Poojary, Aruna, Soltani, Jafar, Pouladfar, Gholamreza, Jafarpour, Zahra, Alinia, Cyrus, Ameen, Hadi, Fitzgerald, David, Paul, Mical, Maor, Yasmin, Strahilevitz, Jacob, Chowers, Michal, Temkin, Elizabeth, Luca, Arnoldo, Ishibashi, Noriomi, Gu, Yoshiaki, Darwish Elhajji, Feras, Karabukayeva, Aizhan, Raka, Denis, Kambaralieva, Baktygul, Zarakauska, Lelde, Zarb, Peter, Hernandez Chena, Blanca Estela, Gonzalez-Diaz, Esteban, Corona-Meléndez, JuanCarlos, Torres Erazo, Darwin Stalin, Loza-Jalil, Suria Elizabeth, Molina, Julio, Candelas, Jose Antonio, Mijovic, Gordana, Duborija-Kovacevic, Natasa, Jong, Eefje, Kluytmans, Jan, van Elzakker, Erika, Schweitzer, Valentijn, Davies, Nicola, Iregbu, Kenneth, Nwajiobi-Princewill, Philip, Nwafia, Ifeyinwa, Fasuyi, Temitayo, Aboderin, Aaron, Elikwu, Charles John, Fadeyi, Abayomi, Ola-Bello, Olafoyekemi, Oduyebo, Oyinlola, Adedosu, Akin Nelson, Ekuma, Agantem, Shaqiri, Erjona, Saleem, Zikria, De Los Reyes, Mari Rose, Tavares, Luis, Kim, Nam Joong, Rachina, Svetlana, Alharthi, Alwaleed R., Enani, Mushira, Faried, Osama, Mirghani, Mohamed, Carevic, Biljana, Radulovic, Lili, Dragovac, Gorana, Tan, Sock Hoon, Taljaard, Jantjie, Chibabhai, Vindana, Joiner, Jennifer, Caston, Juan Jose, Núñez-Núñez, María, Martínez-Marcos, Francisco Javier, Ojeda-Burgos, Guillermo, Menendez, Maria Dolores, Retamar, Pilar, Corzo, Juan E., Rattanaumpawan, Pinyo, Salou, Mounerou, Mnif, Basma, Oncul, Ahsen, Babigumira, Peter Ahabwe, Olweny, James, Marshall, Emily, McCorry, Ann, Aldeyab, Mamoon, Khanna, Priya, Gormley, Cairine, Maloney, Sara, Cooper, Mandelin, Blackburn, Laura, Gessner-Wharton, Mallory, Vu, Lam, Greer, Nickie, Gawrys, Gerard, Kronmann, Lisha, Rios, Edgar, Hudson, Melissa, Lindholm, David A., The Global-PPS network, Vriendenkring VUB, Clinical sciences, Microbiology and Infection Control, and Clinical Biology

Subjects
Adult, Microbiology (medical), Point prevalence survey, Latin Americans, education, Population, MEDLINE, World Health Organization, Essential medicines, Antibiotic prescribing, Anti-Infective Agents, Environmental health, Prevalence, Humans, AcademicSubjects/MED00740, Medicine, Pharmacology (medical), Medical prescription, Biology, Original Research, Pharmacology, education.field_of_study, Adult patients, business.industry, Pharmacology. Therapy, Hospitals, Anti-Bacterial Agents, Anti-Bacterial Agents/therapeutic use, AcademicSubjects/MED00290, Infectious Diseases, Human medicine, AcademicSubjects/MED00230, business
Abstract

ObjectivesThe WHO Access, Watch and Reserve (AWaRe) classification has been developed to support countries and hospitals in promoting rational use of antibiotics while improving access to these essential medicines. We aimed to describe patterns of worldwide antibiotic use according to the AWaRe classification in the adult inpatient population.MethodsThe Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS) collects hospital antibiotic use data using a standardized PPS methodology. Global-PPS 2015, 2017 and 2018 data, collected by 664 hospitals in 69 countries, were categorized into AWaRe groups to calculate proportional AWaRe use, Access-to-Watch ratios and the most common indications for treatment with selected Watch antibiotics. Only prescriptions for systemic antibiotics on adult inpatient wards were analysed.ResultsRegional Access use ranged from 28.4% in West and Central Asia to 57.7% in Oceania, whereas Watch use was lowest in Oceania (41.3%) and highest in West and Central Asia (66.1%). Reserve use ranged from 0.03% in sub-Saharan Africa to 4.7% in Latin America. There were large differences in AWaRe prescribing at country level. Watch antibiotics were prescribed for a range of very different indications worldwide, both for therapeutic and prophylactic use.ConclusionsWe observed considerable variations in AWaRe prescribing and high use of Watch antibiotics, particularly in lower- and upper-middle-income countries, followed by high-income countries. The WHO AWaRe classification has an instrumental role to play in local and national stewardship activities to assess prescribing patterns and to inform and evaluate stewardship activities.

Published
2021

2. Point prevalence survey of antimicrobial use and healthcare-associated infections in Belgian acute care hospitals : results of the Global-PPS and ECDC-PPS 2017

Author

Vandael, Eline, Latour, Katrien, Goossens, Herman, Magerman, Koen, Drapier, Nico, Catry, Boudewijn, Versporten, Ann, Andre, Marie, Aouachria, Samy, Aoun, Mickael, Bafort, Kristof, Bartholomeus, Sofie, Blumental, Sophie, Bothy, Anais, Brands, Christiane, Brassinne, Laetitia, Briquet, Caroline, Cartuyvels, Reinoud, Ceyssens, Clara, Cooreman, Sarah, Decleire, Pierre-Yves, Declercq, Philippe, De Cooman, Liesbeth, De Cuyper, Inge, Degraeve, Dirk, Delaere, Benedicte, Delvallee, Melanie, Desmedt, Marjoleine, Diaz, Victoria, Dragos, Ilisei, Dugernier, Thierry, Elsen, Elodie, Filippin, Lorenzo, Firre, Eric, Frans, Johan, Gabriels, Patrick, Gadisseux, Philippe, Gerard, Michele, Glibert, Bart, Goegebuer, Truus, Gonissen, Viviane, Harrouk, Antoine, Holemans, Xavier, Honore, Aline, Ide, Louis, Jansens, Hilde, Kidd, Francois, Koch, Annelies, Konopnicki, Deborah, Lefevre, Philippe, Lespagnard, Marc, Lorent, Sophie, Maillart, Evelyne, Mallet, Martine, Markowicz, Samuel, Mathieu, Delphine, Michel, Philippe, Noirhomme, Severine, Papin, Pauline, Piette, Anne, Pollet, Leen, Rossi, Camelia, Schatt, Patricia, Sermijn, Erica, Sterckx, Astrid, Steyaert, Sophia, Swinnen, Walter, Teixeira Lopes, Liliana, Thoelen, Inge, Turkova, Myriam, Van den Abeele, Anne-Marie, Van den Berg, Valerie, Van der beek, Danielle, Vanderper, Vanessa, Vandevelde, Marc, Vandewal, Wouter, Van Herendael, Bruno, Vanheule, Geert, Van Hoecke, Frederik, Van Kerkhoven, Dana, Van Liedekerke, Ann, Vanneste, Lorenz, Vekemans, Marc, Vercheval, Christelle, Verhamme, Katia, Verniest, Thessa, Westerlinck, Veerle, Wybo, Ingrid, Belgian Point Prevalence Survey, Swinnen, Walter/0000-0001-5387-149X, and Vriendenkring VUB

Subjects
Male, Antibiotics, Drug resistance, Antimicrobial Stewardship, Medical microbiology, Drug Utilization Review, Belgium, Risk Factors, Acute care, Antimicrobial consumption, Prevalence, Medicine, Pharmacology (medical), Pharmacology & Pharmacy, Point prevalence survey, Child, health care economics and organizations, Public, Environmental & Occupational Health, Medicine(all), Aged, 80 and over, Cross Infection, Pharmacology. Therapy, Middle Aged, Antimicrobial, Anti-Bacterial Agents, Infectious Diseases, Child, Preschool, Female, Life Sciences & Biomedicine, Microbiology (medical), Adult, medicine.medical_specialty, Adolescent, medicine.drug_class, education, Healthcare-associated infections, Microbiology, lcsh:Infectious and parasitic diseases, Young Adult, Internal medicine, Humans, lcsh:RC109-216, Medical prescription, Biology, Aged, Science & Technology, business.industry, Research, Public Health, Environmental and Occupational Health, Infant, Newborn, Infant, Généralités, medicine.disease, Health Surveys, Confidence interval, Pneumonia, Acute care hospitals, Human medicine, business
Abstract

Background: The point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use organized by the European Centre for Disease Prevention and Control (ECDC-PPS) and the Global Point Prevalence Survey of antimicrobial consumption (Global-PPS) were simultaneously performed in Belgian acute care hospitals in 2017. Methods: Belgian acute care hospitals were invited to participate in either the ECDC or Global-PPS. Hospital/ward/patient-level data were collected between September-December 2017. All patients present in the wards at 8 a.m. on the day of the PPS were included. The data of the ECDC and Global-PPS on antimicrobial consumption were pooled. Detailed data on HAIs were analysed for ECDC-PPS. Results: Overall, 110 Belgian acute care hospital sites participated in the ECDC and Global-PPS (countrywide participation rate: 81.4%, 28,007 patients). Overall, a crude prevalence of patients with at least one antimicrobial of 27.1% (95% confidence interval (CI) 26.5-27.6%) was found. The most frequently reported indications were pneumonia (23.2%), urinary tract infections (15.2%) and skin and soft tissue infections (11.9%). The reason for antimicrobial use was recorded for 81.9% of the prescriptions, a stop/review date for 40.8% and compliance with local antibiotic guidelines for 76.6%. In the ECDC-PPS, the crude prevalence of patients with at least one HAI was 7.3% (95%CI 6.8-7.7%). Most frequently reported HAIs were pneumonia (21.6%) and urinary tract infections (21.3%). Conclusions: HAI and antimicrobial use prevalence remained stable in comparison with the previous PPS (7.1% and 27.4% in 2011 and 2015, respectively). Belgian hospitals should be further stimulated to set local targets to improve antibiotic prescribing and reduce HAI., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

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