RT Journal Article
SR Electronic
T1 The 2018 Global Point Prevalence Survey of antimicrobial consumption and resistance in 47 Canadian hospitals: a cross-sectional survey
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E1242
OP E1251
DO 10.9778/cmajo.20200274
VO 9
IS 4
A1 German, Greg J.
A1 Frenette, Charles
A1 Caissy, Jean-Alexandre
A1 Grant, Jennifer
A1 Lefebvre, Marie-Astrid
A1 Mertz, Dominik
A1 Lutes, Sarah
A1 McGeer, Allison
A1 Roberts, Jacqueline
A1 Afra, Kevin
A1 Valiquette, Louis
A1 Émond, Yannick
A1 Carrier, Marie
A1 Lauzon-Laurin, Anaïs
A1 Nguyen, Trong Tien
A1 Al-Bachari, Hamed
A1 Kosar, Justin
A1 Peermohamed, Shaqil
A1 Science, Michelle
A1 Landry, Daniel
A1 MacLaggan, Timothy
A1 Daley, Peter
A1 McDonald, Gerald
A1 Ang, Anita
A1 Chang, Sandra
A1 Lin, Yu-Chen
A1 Tong, Brandon
A1 Malfair, Suzanne
A1 Leung, Victor
A1 Katz, Kevin
A1 Pauwels, Ines
A1 Goossens, Herman
A1 Versporten, Ann
A1 Conly, John
A1 Thirion, Daniel J.G.
YR 2021
UL http://www.cmajopen.ca/content/9/4/E1242.abstract
AB Background: Patient-level surveillance of antimicrobial use (AMU) in Canadian hospitals empowers the reduction of inappropriate AMU and was piloted in 2017 among 14 hospitals in Canada. We aimed to describe AMU on the basis of patient-level data in Canadian hospitals in 2018 in terms of antimicrobial prescribing prevalence and proportions, antimicrobial indications, and agent selection in medical, surgical and intensive care wards.Methods: Canadian adult, pediatric and neonatal hospitals were invited to participate in the standardized web-based cross-sectional Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) conducted in 2018. An identified site administrator assigned all wards admitting inpatients to specific surveyors. A physician, pharmacist or nurse with infectious disease training performed the survey. The primary outcomes were point prevalence rates for AMU over the study period regarding prescriptions, indications and agent selection in medical, surgical and intensive care wards. The secondary outcomes were AMU for resistant organisms and practice appropriateness evaluated on the basis of quality indicators. Antimicrobial consumption is presented in terms of prevalence and proportions.Results: Forty-seven of 118 (39.8%) hospitals participated in the survey; 9 hospitals were primary care centres, 15 were secondary care centres and 23 were tertiary or specialized care centres. Of 13 272 patients included, 33.5% (n = 4447) received a total of 6525 antimicrobials. Overall, 74.1% (4832/6525) of antimicrobials were for therapeutic use, 12.6% (n = 825) were for medical prophylaxis, 8.9% (n = 578) were for surgical prophylaxis, 2.2% (n = 143) were for other use and 2.3% (n = 147) were for unidentified reasons. A diagnosis or indication was documented in the patient’s file at the initiation for 87.3% (n = 5699) of antimicrobials; 62.9% (n = 4106) of antimicrobials had a stop or review date; and 72.0% (n = 4697) of prescriptions were guided by local guidelines.Interpretation: Overall, three-quarters of AMU was for therapeutic use across participating hospitals. Canadian hospitals should be further incentivized to create and adapt local guidelines on the basis of recent antimicrobial resistance data.