Antibiotic Consumption Point Prevalence Survey in a Teaching Hospital in Guatemala

BACKGROUND: Antibiotics are among the most commonly prescribed drugs and are considered a major determinant in the development of resistance. Regionally no regulation on antibiotics exists and resistance is an important and growing problem. Close vigilance to the use and indication of antibiotics prescription need to be reinforced in order to develop better guidelines for its management. METHODS: A point prevalence study of the prescription of antibiotics from all inpatients in the Surgery Department (SD), Intensive Care Unit (ICU), Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) was performed in November 2016. Data were collected using standardized method. RESULTS: Of 231 patients, 193 (83.75%) received one or more antibiotics. The highest rate of prescription occurred in the PICU (96%, 24/25) and SD (90%; 114/127) and the lowest in the ICU (68%; 19/28). The parenteral route was used in 100%. Carbapenems were the most commonly prescribed antibiotic in critical care units (61.53%) and combination therapy with another broad-spectrum antibiotic was found in 50% of cases. Therapeutic prescription, with either clinical or microbiological diagnosis, was indicated in 81.81% of cases; 33.86% (64/189) of which were nosocomial. A positive bacterial culture was identified in 65.4% (151/231) of charts. The rates of identified microorganism through bacterial cultures per department were NICU 95% (35), PICU 79% (19), ICU 68% (13), SD 46% (53). CONCLUSION: These data indicates a high rate of antibiotic broad-spectrum use at the hospital. Considering that almost 20% of cases didn’t have an infectious disease diagnosis, antibiotics prescription seems to be strongly empirical. National antibiotic stewardship policies are required with a multifaceted strategy including education, regulation and greater financial support from the government to impact on antimicrobial resistance rates. DISCLOSURES: All authors: No reported disclosures.