Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications

Antibiotics, Journal Year: 2023, Volume and Issue: 12(5), P. 827 - 827

Published: April 28, 2023

Antimicrobial resistance (AMR) is an increasing global concern, costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several national initiatives slow down rising rates. NAPs also helping key stakeholders understand current antimicrobial utilization patterns The Middle East no exception, with high Antibiotic point prevalence surveys (PPS) provide a better understanding existing consumption trends in hospitals assist the subsequent implementation stewardship programs (ASPs). These important NAP activities. We examined hospital across along documented ASPs. A narrative assessment 24 PPS studies region found that, on average, more than 50% in-patients received antibiotics, Jordan having highest rate 98.1%. Published ranged size from single 18 hospitals. most prescribed antibiotics were ceftriaxone, metronidazole, penicillin. In addition, significant postoperative antibiotic prescribing lasting up five days or longer was common avoid surgical site infections. findings have resulted variety suggested short-, medium-, long-term actions among stakeholders, including governments healthcare workers, improve sustain future order decrease throughout East.

Language: Английский

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A Narrative Review of Antibiotic Prescribing Practices in Primary Care Settings in South Africa and Potential Ways Forward to Reduce Antimicrobial Resistance

Antibiotics, Journal Year: 2023, Volume and Issue: 12(10), P. 1540 - 1540

Published: Oct. 14, 2023

There are concerns with the current prescribing of antibiotics in both private and public primary care settings South Africa. These need to be addressed going forward reduce rising antimicrobial resistance (AMR) rates Concerns include adherence guidelines. Consequently, there is a comprehensively summarise antibiotic utilization patterns from published studies as well potential activities improve prescribing, including indicators stewardship programs (ASPs). Published showed that was an appreciable for patients acute respiratory infections, i.e., 52.9% 78% or more across sectors. However, this not universal, guidelines community health centres. Encouragingly, majority prescribed, albeit often inappropriately, were ‘Access’ group AWaRe (Access/Watch/Reserve) classification rather than ‘Watch’ limit AMR. Inappropriate helped by knowledge regarding antibiotics, AMR ASPs among prescribers care. This needs forward. have shown it crucial use language understand when discussing key aspects enhance appropriate use. Recommended future improved education all groups regularly monitoring against agreed-upon indicators.

Language: Английский

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Antimicrobial Resistance Patterns and Risk Factors Associated with ESBL-Producing and MDR Escherichia coli in Hospital and Environmental Settings in Lusaka, Zambia: Implications for One Health, Antimicrobial Stewardship and Surveillance Systems

Microorganisms, Journal Year: 2023, Volume and Issue: 11(8), P. 1951 - 1951

Published: July 31, 2023

Antimicrobial resistance (AMR) is a public health problem threatening human, animal, and environmental safety. This study assessed the AMR profiles risk factors associated with Escherichia coli in hospital settings Lusaka, Zambia. cross-sectional was conducted from April 2022 to August using 980 samples collected clinical settings. susceptibility testing BD PhoenixTM 100. The data were analysed SPSS version 26.0. Of samples, 51% sources. Overall, 64.5% of tested positive for E. coli, which 52.5% Additionally, 31.8% ESBL, 70.1% isolates. 632 isolates, 48.3% MDR. Most isolates resistant ampicillin (83.4%), sulfamethoxazole/trimethoprim (73.8%), ciprofloxacin (65.7%) while all (100%) some levofloxacin (30.6%). drivers MDR included pus (AOR = 4.6, CI: 1.9-11.3), male sex 2.1, 1.2-3.9), water 2.6, 1.2-5.8). found that common antibiotics used humans. presence concern calls vigorous infection prevention measures surveillance reduce its burdens.

Language: Английский

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Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications

Antibiotics, Journal Year: 2023, Volume and Issue: 12(4), P. 646 - 646

Published: March 24, 2023

There are concerns with excessive antibiotic prescribing among patients admitted to hospital COVID-19, increasing antimicrobial resistance (AMR). Most studies have been conducted in adults limited data on neonates and children, including Pakistan. A retrospective study was four referral/tertiary care hospitals, the clinical manifestations, laboratory findings, prevalence of bacterial co-infections or secondary infections antibiotics prescribed children hospitalized due COVID-19. Among 1237 511 were COVID-19 wards 433 finally included study. The majority COVID-19-positive (85.9%) severe (38.2%), 37.4% ICU. 3.7%; however, 85.5% during their stay (average 1.70 ± 0.98 per patient). Further, 54.3% two via parenteral route (75.5%) for ≤5 days (57.5), most being 'Watch' (80.4%). Increased reported requiring mechanical ventilation high WBCs, CRP, D-dimer ferritin levels (p < 0.001). severity, length setting significantly associated Excessive despite very low infections, requires urgent attention reduce AMR.

Language: Английский

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Tackling antimicrobial resistance in primary care facilities across Pakistan: Current challenges and implications for the future

Journal of Infection and Public Health, Journal Year: 2023, Volume and Issue: 16, P. 97 - 110

Published: Nov. 3, 2023

Antibiotics are gradually becoming less effective against bacteria worldwide, and this issue is of particular concern in economically-developing nations like Pakistan. We undertook a scoping review order to the literature on antimicrobial use, prescribing, dispensing challenges associated with resistance primary care (PC) settings Furthermore, aims identify potential solutions promote appropriate use antimicrobials Following Preferred Reporting Items for Systematic Reviews Meta-Analyses extension reviews (PRISMA-ScR) checklist, comprehensive was conducted used, prescribed dispensed PC Google Scholar Pub-Med were searched period 2000-2023. Papers analyzed basis eligibility i.e., included prescribing practices by general population at homes, prescribers outpatient departments hospitals pharmacists/dispensers community pharmacies, respectively. Two researchers articles thoroughly disagreements resolved through discussion third reviewer. Both quantitative qualitative research studies eligible inclusion. Additionally, selected papers grouped into different themes. identified 4070 out which 46 satisfied our criteria. The findings revealed limited understanding (AMR) physicians pharmacists along inappropriate antibiotics. Moreover, notable prevalence self-medication antibiotics observed among population, underscoring lack awareness knowledge concerning proper antibiotic usage. Given clinical public health implications AMR, Pakistan must prioritize its policies settings. Healthcare professionals (HCPs) need reduce dispensing, improve their AWaRe (access, watch reserve antibiotics) classification guidance, monitor current usage trends, as well implement stewardship (ASP) activities starting targeted locations.

Language: Английский

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Antimicrobial stewardship: knowledge, attitudes and practices regarding antimicrobial use and resistance among non-healthcare students at the University of Zambia

JAC-Antimicrobial Resistance, Journal Year: 2023, Volume and Issue: 5(6)

Published: Nov. 1, 2023

Antimicrobial resistance (AMR) poses a significant threat to the world and could become humanity's next major challenge. This study assessed non-healthcare students' knowledge, attitude practices (KAP) towards antimicrobial use (AMU) AMR at University of Zambia.This cross-sectional was conducted among 443 students from August October 2022 using structured questionnaire. Data analysis done IBM SPSS version 24.0.Of 433 participants, 55.2%, 63.5% 45% had moderate KAP scores regarding AMU AMR. The prevalence self-medication with antibiotics 76.7%. Male participants were less likely have good knowledge (OR = 0.524, 95% CI: 0.347-0.792) positive attitudes 0.585, 0.364-0.940) compared females. Students who studying Engineering Mining more 1.891, 1.197-2.987) those in Social Sciences. Those their fourth fifth years 1.851, 1.147-2.986) first, second third years. Finally, practised self-reported practice 0.442, 0.278-0.702) did not.This demonstrated that All university should be provided education about through free short courses, seminars, workshops, stewardship awareness campaigns.

Language: Английский

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A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications

Medicina, Journal Year: 2023, Volume and Issue: 59(12), P. 2195 - 2195

Published: Dec. 18, 2023

Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care Tanzania, including both public private sectors. These need to be addressed as part national action plan (NAP) Tanzania reduce rising antimicrobial resistance (AMR) rates. Issues include high rates for essentially self-limiting conditions. Consequently, there is a address this. As result, aims this narrative review were comprehensively summarize antibiotic utilization patterns particularly their rationale suggest ways forward improve future practices. Materials Methods: We undertook recently published studies subsequently documented potential activities Potential included instigating quality indicators stewardship programs (ASPs). Results: Published have shown that being excessively prescribed up 95% 96.3% presenting cases depending on sector. This despite appropriateness. High not helped by variable adherence treatment guidelines. also been extensive 'Watch' Overall, majority across sectors, albeit inappropriately, typically from 'Access' group AWaRe (Access/Watch/Reserve) classification rather than limit AMR. The inappropriate linked knowledge regarding antibiotics, AMR, ASPs among prescribers patients. Recommended improved education all groups, instigation updated indicators, regular monitoring against agreed-upon guidelines indicators. Education healthcare professionals should start at undergraduate level continue post qualification. Community advocacy rational use social media dispel misinformation. Conclusion: sub-optimal Tanzania. needs urgently addressed.

Language: Английский

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Prevalence and Etiology of Community- and Hospital-Acquired Pneumonia in Saudi Arabia and Their Antimicrobial Susceptibility Patterns: A Systematic Review

Medicina, Journal Year: 2023, Volume and Issue: 59(4), P. 760 - 760

Published: April 13, 2023

(1) Background and Objectives: Pneumonia is a major cause of morbidity mortality worldwide, including in Saudi Arabia, the prevalence etiology disease varies depending on setting. The development effective strategies can help reduce adverse impact this disease. Therefore, systematic review was conducted to explore community-acquired hospital-acquired pneumonia as well their antimicrobial susceptibility. (2) Materials Methods: Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) 2020 recommendations were followed review. Several databases used perform thorough literature search, papers then assessed eligibility by two independent reviewers. Newcastle-Ottawa Scale (NOS) extract data from relevant research evaluate its quality. (3) Results: This included 28 studies that highlighted fact gram-negative bacteria, particularly Acinetobacter spp. Pseudomonas aeruginosa, common pneumonia, while Staphylococcus aureus Streptococcus responsible children. study also found bacterial isolates showed high resistance rates against several antibiotics, cephalosporins carbapenems. (4) Conclusions: In conclusion, different bacteria are community- Arabia. Antibiotic commonly highlighting need rational antibiotic use prevent further resistance. Moreover, there conduct more regular multicenter assess etiology, resistance, susceptibility patterns pneumonia-causing pathogens

Language: Английский

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Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications

JAC-Antimicrobial Resistance, Journal Year: 2023, Volume and Issue: 6(1)

Published: Dec. 28, 2023

Antimicrobial resistance (AMR) is a global public health problem that fuelled by the inappropriate prescribing of antibiotics, especially those from 'watch' and 'reserve' antibiotic lists. The irrational antibiotics particularly prevalent in developing countries, including Zambia. Consequently, there need to better understand patterns across sectors Zambia as basis for future interventions. This study evaluated using WHO indicators alongside 'access, watch reserve' (AWaRe) classification system post-COVID pandemic at faith-based hospital

Language: Английский

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Antimicrobial resistance in Enterobacterales infections among children in sub-Saharan Africa: a systematic review and meta-analysis

EClinicalMedicine, Journal Year: 2024, Volume and Issue: 70, P. 102512 - 102512

Published: March 8, 2024

The burden of antimicrobial resistance (AMR) has been estimated to be the highest in sub-Saharan Africa (SSA). current study proportion drug-resistant Enterobacterales causing infections SSA children.

Language: Английский

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