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2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean

BACKGROUND: Inappropriate use of antimicrobials is one of the core contributors to antimicrobial resistance. While hospitals create high selection pressures on bacteria due to the high quantity and broader spectrum of antibiotics used, information on antimicrobial use at the patient level in the Car...

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Autores principales: Hsieh, Jenny, Sati, Hatim, Ramon-Pardo, Pilar, Bruinsma, Nienke, F. Galas, Marcelo, Marie Rwangabwoba, Jean, Irene. Fletcher Payton, Zoila, Bonet, Mariano, Forde, Corey A, Alladin-Karan, Bibi A, Mohamed-Rambaran, Pheona, Chery, Gemma, Singh, Nalini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809577/
http://dx.doi.org/10.1093/ofid/ofz360.1714
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author Hsieh, Jenny
Sati, Hatim
Ramon-Pardo, Pilar
Bruinsma, Nienke
F. Galas, Marcelo
Marie Rwangabwoba, Jean
Irene. Fletcher Payton, Zoila
Bonet, Mariano
Forde, Corey A
Alladin-Karan, Bibi A
Mohamed-Rambaran, Pheona
Chery, Gemma
Singh, Nalini
author_facet Hsieh, Jenny
Sati, Hatim
Ramon-Pardo, Pilar
Bruinsma, Nienke
F. Galas, Marcelo
Marie Rwangabwoba, Jean
Irene. Fletcher Payton, Zoila
Bonet, Mariano
Forde, Corey A
Alladin-Karan, Bibi A
Mohamed-Rambaran, Pheona
Chery, Gemma
Singh, Nalini
author_sort Hsieh, Jenny
collection PubMed
description BACKGROUND: Inappropriate use of antimicrobials is one of the core contributors to antimicrobial resistance. While hospitals create high selection pressures on bacteria due to the high quantity and broader spectrum of antibiotics used, information on antimicrobial use at the patient level in the Caribbean is sparse. In response, PAHO implemented a standardized WHO methodology to engage national leaderships, build local capacity, and facilitate the use of data to inform antimicrobial stewardship programs (ASP) in the Caribbean. METHODS: Point prevalence surveys (PPS) were performed in four acute care hospitals in Barbados, Guyana and Saint Lucia between June and July 2018. Medical records of all inpatients were reviewed to collect information on antibiotic use, indications and use of laboratory services (Figure 1). A hospital questionnaire was used to assess hospital infrastructure, policy and practices, and monitoring and feedback systems (Figure 2). Training on PPS methods and electronic data collection tool in REDCap™ were provided to build local capacity and identify potential ASP leaderships. A standardized data validation, analysis and reporting system was built in R to streamline the process. Results and recommendations were disseminated to national authorities and stakeholders to support hospital and national decision-making and training for healthcare providers (Figure 3). RESULTS: A total of 60 physicians, nurses, pharmacists, laboratory technicians, and infection control specialists were trained and participated in the PPS. The survey collected records of 816 patients in which 442 (54%) were females and 374 (46%) were males. In total, 356 (44%) patients received 551 antibiotics. Overall, 300 (75%) of 398 indications for antibiotic use were treatment and 72 (18%) were prophylaxis. A higher use of parenteral antibiotics (79%) was observed compared with oral antibiotics (21%). Antibiotic prescribing patterns differed across hospitals. The most commonly used antibiotics were metronidazole (12%) and amoxicillin/clavulanate (11%). CONCLUSION: The PPS method provided a feasible and effective way to collect baseline data and identify target areas for interventions. Engaging national leaderships and building local capacity offered a sustainable way in optimizing antimicrobial use in resource-limited settings. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68095772019-10-28 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean Hsieh, Jenny Sati, Hatim Ramon-Pardo, Pilar Bruinsma, Nienke F. Galas, Marcelo Marie Rwangabwoba, Jean Irene. Fletcher Payton, Zoila Bonet, Mariano Forde, Corey A Alladin-Karan, Bibi A Mohamed-Rambaran, Pheona Chery, Gemma Singh, Nalini Open Forum Infect Dis Abstracts BACKGROUND: Inappropriate use of antimicrobials is one of the core contributors to antimicrobial resistance. While hospitals create high selection pressures on bacteria due to the high quantity and broader spectrum of antibiotics used, information on antimicrobial use at the patient level in the Caribbean is sparse. In response, PAHO implemented a standardized WHO methodology to engage national leaderships, build local capacity, and facilitate the use of data to inform antimicrobial stewardship programs (ASP) in the Caribbean. METHODS: Point prevalence surveys (PPS) were performed in four acute care hospitals in Barbados, Guyana and Saint Lucia between June and July 2018. Medical records of all inpatients were reviewed to collect information on antibiotic use, indications and use of laboratory services (Figure 1). A hospital questionnaire was used to assess hospital infrastructure, policy and practices, and monitoring and feedback systems (Figure 2). Training on PPS methods and electronic data collection tool in REDCap™ were provided to build local capacity and identify potential ASP leaderships. A standardized data validation, analysis and reporting system was built in R to streamline the process. Results and recommendations were disseminated to national authorities and stakeholders to support hospital and national decision-making and training for healthcare providers (Figure 3). RESULTS: A total of 60 physicians, nurses, pharmacists, laboratory technicians, and infection control specialists were trained and participated in the PPS. The survey collected records of 816 patients in which 442 (54%) were females and 374 (46%) were males. In total, 356 (44%) patients received 551 antibiotics. Overall, 300 (75%) of 398 indications for antibiotic use were treatment and 72 (18%) were prophylaxis. A higher use of parenteral antibiotics (79%) was observed compared with oral antibiotics (21%). Antibiotic prescribing patterns differed across hospitals. The most commonly used antibiotics were metronidazole (12%) and amoxicillin/clavulanate (11%). CONCLUSION: The PPS method provided a feasible and effective way to collect baseline data and identify target areas for interventions. Engaging national leaderships and building local capacity offered a sustainable way in optimizing antimicrobial use in resource-limited settings. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809577/ http://dx.doi.org/10.1093/ofid/ofz360.1714 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Hsieh, Jenny
Sati, Hatim
Ramon-Pardo, Pilar
Bruinsma, Nienke
F. Galas, Marcelo
Marie Rwangabwoba, Jean
Irene. Fletcher Payton, Zoila
Bonet, Mariano
Forde, Corey A
Alladin-Karan, Bibi A
Mohamed-Rambaran, Pheona
Chery, Gemma
Singh, Nalini
2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean
title 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean
title_full 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean
title_fullStr 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean
title_full_unstemmed 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean
title_short 2034. Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean
title_sort 2034. standardized point prevalence survey on antibiotic use to inform antimicrobial stewardship strategies in the caribbean
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809577/
http://dx.doi.org/10.1093/ofid/ofz360.1714
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