Point prevalence survey of antibiotic use in hospitals in Latin American countries

Levy Hara G.; Rojas-Cortes R.; Molina León H.F.; Dreser Mansilla A.; Alfonso Orta I.; Rizo-Amezquita J.N.; Santos Herrera R.G.; Mendoza De Ayala S.; Arce Villalobos M.; Mantilla Ponte H.; Davila E.; Aguilar G.; Porrás A.; Ramón-Pardo P.; Castro J.L.; Guzmán D.; Rioseco M.L.; Labarca J.; Madriz J.P.D.; Cubero J.M.; Calderón A.R.; Alfaro M.; Soto L.A.; Aayon A.; Oreamuno T.J.; Jimenez Z.; Sequeira A.; Hernández J.M.; Lavaut J.L.C.; Meriño D.C.; Ruisanchez E.F.; Sánchez D.P.; Garcell H.G.; Socias J.J.P.; Diáz E.P.; Lunar N.A.C.; Lancis I.F.; Ramírez J.A.Á.; Leyte M.L.; Rosabal A.M.; Estrada E.A.; Cano M.; Mendez L.; Eiriz A.C.; Menendez L.P.; Fernández G.F.; Ayala R.R.; Monroy S.; Menjívar R.; Martínez C.E.A.; Cabrera D.; Delgado S.M.M.; Guzmán G.A.M.; Mejiá R.; Rodríguez C.; Alvarenga S.; Alvarado M.; De Zelaya R.D.C.A.; Arevalo G.; Parada G.; Cuellar L.; Ruiz A.H.; Pinedo Y.A.; Vergaray E.S.; Gil L.E.V.; Ibazeta B.G.I.; Ricra E.D.G.; Segura R.E.; Apac C.G.; Inga J.C.; Diáz R.H.; Vigo M.V.; Cuba C.M.; Vilcapoma P.; Angles-Yanqui E.; Terrones D.R.M.; Robles R.T.; Resurrección C.; Gonzalez A.C.; Antezana M.; Zegarra S.T.; Villegas-Chiroque M.; Diáz-Sipión R.; Benítez-Peche J.; Rosas J.L.A.; Ruiz J.L.G.; Fernández A.M.H.; Vargas J.A.F.; Araujo J.; Garciá F.J.A.; Rivera Z.C.; Colín V.M.; Ríos K.B.; Blanquel J.I.H.; De La Garza E.A.; Gutierrez H.H.; León K.; Lara H.E.P.; Arias C.B.; Garay E.A.; Sanabria G.E.; Menchaca L.M.; Vire N.L.; Acuña D.; Caballero E.G. · Journal of Antimicrobial Chemotherapy (2022) · DOI: 10.1093/jac/dkab459

Resumen

Background: Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals. Methods: An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCapVC ) through a mobile device was used for data collection. Results: Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6%received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3%of cases. Conclusions: Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America. © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.