Point prevalence survey of antimicrobial use during the COVID-19 pandemic among different hospitals in Pakistan : findings and implications

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Saleem, Zikria and Haseeb, Abdul and Godman, Brian and Batool, Narjis and Altaf, Ummara and Ahsan, Umar and Khan, Faiz Ullah and Mustafa, Zia Ul and Nadeem, Muhammad Umer and Farrukh, Muhammad Junaid and Mugheera, Muhammad and Rehman, Inaam Ur and Khan, Asma Fareed and Saeed, Hamid and Hossain, Mohammad Akbar and Raafat, Mohamed and Radwan, Rozan Mohammad and Iqbal, Muhammad Shahid (2022) Point prevalence survey of antimicrobial use during the COVID-19 pandemic among different hospitals in Pakistan : findings and implications. Antibiotics, 12 (1). 70. ISSN 2079-6382 (https://doi.org/10.3390/antibiotics12010070)

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Abstract

The COVID-19 pandemic has significantly influenced antimicrobial use in hospitals raising concerns regarding increased antimicrobial resistance (AMR) through their overuse. The objective of this study was to assess patterns of antimicrobial prescribing during the current COVID-19 pandemic among hospitals in Pakistan, including the prevalence of COVID-19. A point prevalence survey (PPS) was performed among 11 different hospitals from November 2020 to January 2021. The study included all hospitalized patients receiving an antibiotic on the day of the PPS. The Global-PPS web-based application was used for data entry and analysis. Out of 1024 hospitalized patients, 662 (64.64%) received antimicrobials. The top three most common indications for antimicrobial use were pneumonia (13.3%), central nervous system infections (10.4%) and gastrointestinal indications (10.4%). Ceftriaxone (26.6%), metronidazole (9.7%) and vancomycin (7.9%) were the top three most commonly prescribed antimicrobials among surveyed patients, with the majority of antibiotics administered empirically (97.9%). Most antimicrobials for surgical prophylaxis were given for more than one day, which is a concern. Overall, a high percentage of antimicrobial use, including broad-spectrums, was seen among the different hospitals in Pakistan during the current COVID-19 pandemic. Multifaceted interventions are needed to enhance rational antimicrobial prescribing including limiting their prescribing post-operatively for surgical prophylaxis.

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