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Du Z, Zhou Q, Shen Y, Lu R, Jiang Y, Zhu H. Analysis of antimicrobial drug usage in psychiatric specialized hospitals during the pandemic in China. Expert Rev Anti Infect Ther 2024:1-6. [PMID: 38696326 DOI: 10.1080/14787210.2024.2351022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/13/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND This study aims to compare antimicrobial drug usage in our hospital to Jiangsu Province and China from 2020 to 2022. RESEARCH DESIGN AND METHODS A detailed analysis was performed using data from the National Antimicrobial Drug Clinical Application Monitoring Network. Several parameters were studied: the rate of antimicrobial drug use, number and types of drugs used, the rate of combined use, rate of microbiological examinations, drug use intensity, and cumulative Defined Daily Doses (DDDs). RESULTS From 2020 to 2022, our hospital's antimicrobial drug usage rate was consistently lower than Jiangsu Province and China. The average number of drug types and the combined drug use rate were higher in 2020 but fell below those in Jiangsu Province and China in 2021 and 2022. Our microbiological examination rate consistently surpassed that of Jiangsu Province and China. Furthermore, our Antimicrobial Usage Density and cumulative DDDs were notably lower. While AUD remained stable, DDDs showed a decreasing trend. The most dominant drug in DDDs was cefditoren, a third-generation cephalosporin. CONCLUSIONS During the pandemic years, our hospital not only met the requirements for antimicrobial drug usage, microbiological examination, AUD, and cumulative DDDs but also demonstrated a consistent year-by-year decrease in drug usage and DDDs.
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Affiliation(s)
- Zhiqiang Du
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Yuan Shen
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Rongrong Lu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Ying Jiang
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Haohao Zhu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
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Lagadinou M, Tsami E, Deligakis A, Paraskevas T, Michailides C, Velissaris D, Gkentzi D, Marangos M. Knowledge and Attitudes of Healthcare Workers towards Antibiotic Use and Antimicrobial Resistance in Two Major Tertiary Hospitals in Western Greece. Antibiotics (Basel) 2023; 12:1583. [PMID: 37998785 PMCID: PMC10668655 DOI: 10.3390/antibiotics12111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/16/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Antibiotic resistance (ABR) and antimicrobial stewardship arethe two sides of the same coin that constitute a public health hydra. This study aimed to assessthe knowledge and attitude of healthcare workers (HCWs), on antibiotic use and antimicrobial resistance in Western Greece. A total of 200 healthcare workers (doctors, nurses, and others) from the two largest tertiary hospitals in Western Greece were included in our survey. HCWs seem not to decide based on patient opinion in order to prescribe antibiotics. Approximately 97% of them are aware of their main adverse effects. Remarkably, 25% of respondents prescribe antibiotics due to diagnostic uncertainty, and 32.5% of them prescribe antibiotics based on their experience. HCWs statedthat they do not report adverse effects often. Inappropriate antibiotic prescriptions were mentioned as the main reason for bacterial resistance to antimicrobials. Monitoring the patient's treatment progress, using electronic prescriptions, and adhering to international guidelines were suggested as solutions to the problem. Post Hoc analysis showed that nursing staff apply to the national guidelines (p: 0.011) and use electronic prescriptions (p: 0.003) less often compared to consultants, doctor directors, and trainees. The findings of our survey may be useful for the development of future national education programs and interventions thatmay improve healthcare workers' knowledge and ability to manage antibiotics.
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Affiliation(s)
- Maria Lagadinou
- Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Achaia, Greece; (T.P.); (C.M.); (D.V.); (M.M.)
- Department of Medical School, University of Patras, 26504 Greece, Achaia, Greece;
| | - Elpida Tsami
- Department of Surgery, “Saint Andrew” General Hospital of Patras, 26334 Patras, Achaia, Greece; (E.T.); (A.D.)
| | - Apostolos Deligakis
- Department of Surgery, “Saint Andrew” General Hospital of Patras, 26334 Patras, Achaia, Greece; (E.T.); (A.D.)
| | - Themistoklis Paraskevas
- Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Achaia, Greece; (T.P.); (C.M.); (D.V.); (M.M.)
| | - Christos Michailides
- Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Achaia, Greece; (T.P.); (C.M.); (D.V.); (M.M.)
| | - Dimitrios Velissaris
- Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Achaia, Greece; (T.P.); (C.M.); (D.V.); (M.M.)
- Department of Medical School, University of Patras, 26504 Greece, Achaia, Greece;
| | - Despoina Gkentzi
- Department of Medical School, University of Patras, 26504 Greece, Achaia, Greece;
- Department of Pediatrics, University General Hospital of Patras, 26504 Patras, Achaia, Greece
| | - Markos Marangos
- Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Achaia, Greece; (T.P.); (C.M.); (D.V.); (M.M.)
- Department of Medical School, University of Patras, 26504 Greece, Achaia, Greece;
- Department of Infectious Diseases, University General Hospital of Patras, 26504 Patras, Achaia, Greece
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Ali S, Ryan L. WAAW - raising antimicrobial awareness in a tertiary University Hospital, Dublin. Ir J Med Sci 2023; 192:2283-2284. [PMID: 36576668 PMCID: PMC9795946 DOI: 10.1007/s11845-022-03263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Saied Ali
- Department of Clinical Microbiology, St. Vincent's University Hospital, Elm Park, Dublin, D04 T6F4, Ireland.
| | - Laura Ryan
- Department of Clinical Microbiology, St. Vincent's University Hospital, Elm Park, Dublin, D04 T6F4, Ireland
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Nemr N, Kishk RM, Elsaid NMAB, Louis N, Fahmy E, Khattab S. Knowledge, attitude, and practice (KAP) of antimicrobial prescription and its resistance among health care providers in the COVID-19 era: A cross sectional study. PLoS One 2023; 18:e0289711. [PMID: 37561762 PMCID: PMC10414618 DOI: 10.1371/journal.pone.0289711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
Antimicrobial resistance (AMR) is considered as a global health and development threat. During COVID-19 pandemic, there has been an increase in antimicrobial resistance. Health care providers (HCPs) play the main role in facing antibiotic resistance because they have the authority to prescribe antibiotics during clinical practice as well as in promoting patients' compliance with therapies and avoid self-medication. So, this study will serve as an important source of information in context with Covid19 pandemic in Egypt. The data was collected using a validated standardized self-administered online questionnaire compromised of four sections: socio-demographic data of the HCPs, the general knowledge on antibiotics and AMR, the HCP attitude towards antibiotic prescription and AMR and the practice in applying the appropriate antibiotic prescription. Most of HCPs (93.7%) recorded good knowledge level about antibiotic prescription and antimicrobial resistance with mean score of knowledge13.21 ± 1.83. About 79% of HCPs recorded a positive attitude towards proper antibiotic prescription with mean score of attitudes 63.02 ± 7.68. Fifty four percent of HCPs demonstrated a good level of practice with mean score of practice 9.75 ± 2.17. In conclusion, HCPs in our study have a good level of knowledge and attitude about antibiotics. However lower level of proper practice towards the problem of AMR in COVID19 era was noticed. Implementation of effective policies and guidelines is crucial to evaluate the antimicrobial use especially in the COVID-19 era to reduce the unintended consequences of the misuse of antibiotics and its impact on AMR.
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Affiliation(s)
- Nader Nemr
- Endemic and Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Rania M. Kishk
- Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Noha M. Abu Bakr Elsaid
- Public Health, Community, Environmental and Occupational Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Department of Basic Medical Sciences, Faculty of Medicine, King Salman International University, South Sinai, Egypt
| | - Nageh Louis
- Endemic and Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Eman Fahmy
- Internal Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sally Khattab
- Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Valderrama-Rios MC, Nocua-Báez LC, Álvarez-Moreno CA, Cortes JA. Comment on: Gaps and barriers in the implementation and functioning of antimicrobial stewardship programmes: results from an educational and behavioural mixed methods needs assessment in France, the United States, Mexico and India. JAC Antimicrob Resist 2023; 5:dlad050. [PMID: 37124073 PMCID: PMC10141762 DOI: 10.1093/jacamr/dlad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Affiliation(s)
- Martha Carolina Valderrama-Rios
- Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Oficina de Investigación Clínica, Calle 44 no. 59-75, Primer piso, Bogotá, Colombia
| | - Laura Cristina Nocua-Báez
- Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Oficina de Investigación Clínica, Calle 44 no. 59-75, Primer piso, Bogotá, Colombia
- Infectious Diseases Service, Hospital Universitario Nacional, Bogotá, Colombia
| | - Carlos Arturo Álvarez-Moreno
- Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Oficina de Investigación Clínica, Calle 44 no. 59-75, Primer piso, Bogotá, Colombia
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Elbehiry A, Marzouk E, Abalkhail A, El-Garawany Y, Anagreyyah S, Alnafea Y, Almuzaini AM, Alwarhi W, Rawway M, Draz A. The Development of Technology to Prevent, Diagnose, and Manage Antimicrobial Resistance in Healthcare-Associated Infections. Vaccines (Basel) 2022; 10:2100. [PMID: 36560510 PMCID: PMC9780923 DOI: 10.3390/vaccines10122100] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
There is a growing risk of antimicrobial resistance (AMR) having an adverse effect on the healthcare system, which results in higher healthcare costs, failed treatments and a higher death rate. A quick diagnostic test that can spot infections resistant to antibiotics is essential for antimicrobial stewardship so physicians and other healthcare professionals can begin treatment as soon as possible. Since the development of antibiotics in the last two decades, traditional, standard antimicrobial treatments have failed to treat healthcare-associated infections (HAIs). These results have led to the development of a variety of cutting-edge alternative methods to combat multidrug-resistant pathogens in healthcare settings. Here, we provide an overview of AMR as well as the technologies being developed to prevent, diagnose, and control healthcare-associated infections (HAIs). As a result of better cleaning and hygiene practices, resistance to bacteria can be reduced, and new, quick, and accurate instruments for diagnosing HAIs must be developed. In addition, we need to explore new therapeutic approaches to combat diseases caused by resistant bacteria. In conclusion, current infection control technologies will be crucial to managing multidrug-resistant infections effectively. As a result of vaccination, antibiotic usage will decrease and new resistance mechanisms will not develop.
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Affiliation(s)
- Ayman Elbehiry
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City 32511, Egypt
| | - Eman Marzouk
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia
| | - Adil Abalkhail
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia
| | - Yasmine El-Garawany
- Clinical Pharmacy Program, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
| | - Sulaiman Anagreyyah
- Department of Preventive Medicine, King Fahad Armed Hospital, Jeddah 23311, Saudi Arabia
| | - Yaser Alnafea
- Department of Statistics, King Fahad Armed Hospital, Jeddah 23311, Saudi Arabia
| | - Abdulaziz M. Almuzaini
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Waleed Alwarhi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed Rawway
- Biology Department, College of Science, Jouf University, Sakaka 42421, Saudi Arabia
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Assiut 71524, Egypt
| | - Abdelmaged Draz
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 52571, Saudi Arabia
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Bedekelabou AP, Oyetola DW, Coulibaly ZL, Akinsola O, Bada-Alambedji R. First assessment of the knowledge, attitudes, and practices of health actors in Togo and Ivory Coast in regard to antibiotic resistance. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.108-123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and Aim: Bacterial resistance to antibiotics has now become a threat to global public health. This study aimed to assess the knowledge, attitudes, and practices of health actors in relation to antibiotic resistance (ABR) in two African countries.
Materials and Methods: A cross-sectional and descriptive questionnaire study was conducted in Ivory Coast and Togo from August 2020 to July 2021. Actors were interviewed both in person 63% (n = 141) and remotely due to COVID-19 restrictions. Qualitative variables were described by frequencies and quantitative variables by the mean and associated standard deviation. The bivariate analysis was conducted through the Chi-square test and exact Fisher test with an acceptable risk of 5%.
Results: The results showed that 88% and 50% of the actors from Togo and Ivory Coast, respectively, had a good knowledge of ABR even if most of the stakeholders had limited knowledge of antibiotics that are banned or of critical importance in human and animal medicine. More than 75% of the actors had good perceptions in regard to ABR and these were significantly related to their profession. As for the factors leading to an increase in ABR, the interviewees perceived self-medication in humans as the main contributing factor. Approximately 70% of the actors admitted to following inadequate practices in terms of the use and/or distribution of antibiotics, and 58% and 46% of them used preventive antibiotic therapy in Togo and Ivory Coast, respectively. Similarly, in the two countries, 39% and 69% of the actors, respectively, claimed that they do not systematically use the antibiogram, and 69% and 61% of drug distributors, also respectively, admitted to occasionally selling antibiotics without a prescription. Finally, more than 80% thought that the authorities in their country did not communicate sufficiently about ABR. Among the actions that could help to combat ABR, actors considered the strengthening of controls on the distribution of antibiotics and the education of nonprofessionals on the importance of antibiotic preservation as priorities.
Conclusion: Although this first study had some limitations, that is, the low number of surveyed actors and non-standardized questionnaire used, it revealed that health actors in Togo and Ivory Coast have a good knowledge and perception in regard to antibiotics and ABR, but also follow inadequate practices.
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Affiliation(s)
- Andre Pouwedeou Bedekelabou
- Inter State School of Science and Veterinary Medicine of Dakar, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Délé Wilfried Oyetola
- Inter State School of Science and Veterinary Medicine of Dakar, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Zanan Lassina Coulibaly
- Inter State School of Science and Veterinary Medicine of Dakar, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Olouwamouyiwa Akinsola
- Inter State School of Science and Veterinary Medicine of Dakar, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Rianatou Bada-Alambedji
- Inter State School of Science and Veterinary Medicine of Dakar, Cheikh Anta Diop University of Dakar, Dakar, Senegal
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