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Li Q, Song M, Hu Z, Ding Y, Huang C, Liu J. Pediatric respiratory pathogen dynamics in Southern Sichuan, China: a retrospective analysis of gender, age, and seasonal trends. Front Pediatr 2024; 12:1374571. [PMID: 39086626 PMCID: PMC11288815 DOI: 10.3389/fped.2024.1374571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Objective To address the research gap in the epidemiology of pediatric respiratory tract infections (RTIs) in Luzhou, Southern Sichuan, China, by analyzing respiratory pathogens in a large pediatric cohort from 2018 to 2021, covering the pre- and during-COVID-19 periods. Methods This study conducted a retrospective analysis of children with RTIs in Luzhou from July 2018 to January 2021. Strict exclusion criteria were applied to ensure an accurate representation of the pediatric population. Pathogen detection included viruses, bacteria, and atypical agents. Results Pathogens were identified in 52.8% of 12,546 cases. Viruses accounted for 32.2% of infections, bacteria for 29.8%, and atypical agents for 29.7%, with significant findings of Staphylococcus aureus, Moraxella catarrhalis, and Mycoplasma pneumoniae. Age-related analysis indicated a higher incidence of bacterial infections in infants and viral infections in preschool-aged children, with atypical pathogens being most prevalent in 3-5-year-olds. Gender-based analysis, adjusted for age, revealed similar overall pathogen presence; however, females were more susceptible to viral infections, while males were more prone to Streptococcus pneumoniae. Notably, there was an unusual increase in pathogen cases during spring, potentially influenced by behavioral changes and public health measures related to COVID-19. Co-infections were identified as a significant risk factor for the development of pneumonia. Conclusion The study provides essential insights into the epidemiology of respiratory pathogens in pediatric populations, emphasizing the need for healthcare strategies tailored to age, gender, and seasonality. The findings highlight the impact of environmental and public health factors, including COVID-19 measures, on respiratory pathogen prevalence, underscoring the importance of targeted diagnostic and treatment protocols in pediatric respiratory infections.
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Affiliation(s)
- Qing Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Min Song
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhi Hu
- Department of Medical Laboratory, Southwest Medical University, Luzhou, China
| | - Yinhuan Ding
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chengliang Huang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jinbo Liu
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Alosaimi HM, Alshammari MK, Fetyani MM, Allehidan MS, Almalki TJ, Hussain KH, Hussain HH, Althobaiti MD, Alharbi AS, Alharthi AA, Al-Shammari AA, Al Jamea ZA, Alamro RA, Najmi A. Point prevalence survey of antibiotics use among hospitalised neonates and children in Saudi Arabia: findings and implications. J Pharm Policy Pract 2024; 17:2371411. [PMID: 39011353 PMCID: PMC11249164 DOI: 10.1080/20523211.2024.2371411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/18/2024] [Indexed: 07/17/2024] Open
Abstract
Background Neonates and children are more susceptible to a variety of infections, leading to frequent antibiotic prescriptions. However, the inappropriate use of antibiotics leads to antibiotic resistance and higher mortality rates. Therefore, this study aimed to determine the prevalence of antibiotic use, and current antibiotic prescribing practices among neonates and children admitted in the selected hospitals of Saudi Arabia. Methods A cross-sectional study was conducted from September to November 2023 to assess the prevalence of antibiotic use, and the current antibiotic prescribing practices across six hospitals of Saudi Arabia. Results The study included 499 children and neonates, with 94.6% receiving antibiotic prescriptions. The most frequently prescribed antibiotic class was third-generation cephalosporin (31.5%), with ceftriaxone being the most commonly prescribed antibiotic (15%). The majority of patients were prescribed one antibiotic (81.4%), and the intravenous route (96.4%) was the primary route for administration. The majority of patients were prescribed antibiotics empirically (69.7%), and community-acquired infections (64.2%) were the most common type of infection for antibiotic prescription. Similarly, sepsis (39.2%) was the most common indication for antibiotics, and the majority of prescribed antibiotics (61.7%) belonged to the 'Watch' category as per WHO AWaRe classification. Conclusion Our study revealed excessive antibiotic consumption in neonates and children, therefore quality improvement programmes including antimicrobial stewardship programmes are urgently needed to address ongoing issues.
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Affiliation(s)
- Hind M Alosaimi
- Department of Pharmacy Services Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
| | - Mohammed K Alshammari
- Department of Clinical Pharmacy, King Fahad Medical City, Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Mohammad M Fetyani
- Department of Pharmacy Services, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
| | - Maha S Allehidan
- Department of Pharmacy Services, NICU/Pediatric Clinical Pharmacist, Alyamam Hospital, Second Health Cluster, Riyadh, Saudi Arabia
| | - Tahani J Almalki
- Pharmaceutical Care Administration, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | - Khansa H Hussain
- Department of Cardiac Science, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Haifaa H Hussain
- Department of Nursing, Advanced Practice Nurse, Pediatric Nurse Practitioner, King Faisal Specialist Hospital and Research Center, Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Mohammed D Althobaiti
- Department of Medical Surgical Nursing, King Faisal Specialist Hospital & Research Center, Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Abrar S Alharbi
- Department of Pharmaceutical Services, Maternity and Children's Hospital, West Zone, Kingdom of Saudi Arabia, Mecca, Saudi Arabia
| | | | - Amosha A Al-Shammari
- Department of Pharmacy, Maternity and Children Hospital in Rafah, Kingdom of Saudi Arabia, Rafha, Saudi Arabia
| | - Zainab A Al Jamea
- Department of Pharmaceutical Care, King Fahd Hospital of University, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Rayed A Alamro
- Department of Pharmacy Services, Dr. Sulaiman Al Habib Medical Group Alrayyan Hospital, Riyadh, Saudi Arabia
| | - Ali Najmi
- Pharmaceutical Care Administration, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
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Ul Mustafa Z, Batool A, Ibrar H, Salman M, Khan YH, Mallhi TH, Meyer JC, Godman B, Moore CE. Bacterial co-infections, secondary infections and antimicrobial use among hospitalized COVID-19 patients in the sixth wave in Pakistan: findings and implications. Expert Rev Anti Infect Ther 2024; 22:229-240. [PMID: 38146949 DOI: 10.1080/14787210.2023.2299387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/15/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Previous studies in Pakistan have shown considerable over prescribing of antibiotics in patients hospitalized with COVID-19 despite very low prevalence of bacterial infections. Irrational use of antibiotics will worsen antimicrobial resistance (AMR). METHODS Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave. RESULTS A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves. CONCLUSION There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.
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Affiliation(s)
- Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan, Pakistan
| | - Arfa Batool
- Department of Medicine, Sheikh Zaid Medical College, Rahim Yar Khan, Pakistan
| | - Hadia Ibrar
- Department of Medicine, Wah Medical College, Rawalpindi, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow, UK
| | - Catrin E Moore
- Centre for Neonatal and Pediatric Infection, St. George's University of London, London, UK
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Mustafa ZU, Khan AH, Salman M, Harun SN, Meyer JC, Godman B, Seaton RA. Healthcare-associated infections among neonates and children in Pakistan: findings and the implications from a point prevalence survey. J Hosp Infect 2023; 141:142-151. [PMID: 37774930 DOI: 10.1016/j.jhin.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) increase morbidity, mortality and costs. The overall prevalence of HAIs is greater in low- and middle-income countries due to poor resources and infrastructure, with the incidence of HAIs greater among neonates and children. There is a need to understand the current situation in Pakistan including key drivers to improve future care. METHODS Point prevalence survey (PPS) of HAIs in the children's wards of 19 public sector secondary- and tertiary-care hospitals of Pakistan and associated key drivers. RESULTS A total of 1147 children were included in the PPS. 35.7% were neonates with 32.8% aged >1-5 years. 35.2% were admitted to the intensive care units (ICUs). Peripheral, central venous and urinary catheters were present in 48%, 2.9% and 5.6% of the patients, respectively. A total of 161 HAIs from various pathogens were observed in 153 cases, giving a prevalence of 13.3%. The majority of HAIs were caused by Staphylococcus aureus (31.7%) followed by Klebsiella pneumoniae (22.9%) and Escherichia coli (17.4%). Bloodstream infections were identified in 42 cases followed by lower-respiratory-tract infections in 35. Increased length of hospital stays and being admitted to the ICU, 'rapidly fatal' patients under the McCabe and Jackson criteria, central and peripheral catheterization, and invasive mechanical ventilation were, associated with higher HAIs (P<0.001). 99.7% of HAI patients fully recovered and were discharged from the hospital. CONCLUSION There is a high prevalence of HAIs among neonates and children admitted to health facilities in Pakistan. Infection prevention and control measures should be implemented to help prevent future HAIs.
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Affiliation(s)
- Z U Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan, Pakistan.
| | - A H Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - M Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
| | - S N Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - J C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa
| | - B Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa; Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow, UK
| | - R A Seaton
- Queen Elizabeth University Hospital, Glasgow, UK; Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Glasgow, UK
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Harmain ZU, Alkubaisi NA, Hasnain M, Salman M, Baraka MA, Mustafa ZU, Khan YH, Mallhi TH, Meyer JC, Godman B. Awareness and Practices towards Vaccinating Their Children against COVID-19: A Cross-Sectional Study among Pakistani Parents. Healthcare (Basel) 2023; 11:2378. [PMID: 37685412 PMCID: PMC10487428 DOI: 10.3390/healthcare11172378] [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: 07/04/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
There are typically lower COVID-19 vaccination rates among developing versus higher-income countries, which is exacerbated by greater vaccine hesitancy. However, despite the increasing evidence of safety, parents are still reluctant to vaccinate their children against COVID-19. This is a concern in countries experiencing successive waves, such as Pakistan. Consequently, the objective of this study was to gain better understanding and practice regarding parents vaccinating their children against COVID-19 in Pakistan. A cross-sectional study was conducted to measure parents' attitudes towards vaccinating their children. In total, 451 parents participated in the study, giving a response rate of 70.4%; 67.4% were female, 43.2% belonged to the 40-49 years age group, and 47.7% had three children, with 73% of parents fully immunized against COVID-19. We found that 84.7% of parents did not consider COVID-19 to be a very serious issue, and 53.9% considered that their children were not at high risk of COVID-19. Overall, only a quarter of the study participants had currently vaccinated their children and 11.8% were willing to vaccinate their children in the near future. Parents who had a better knowledge of COVID-19, secondary or higher education, children who had chronic illness, and those parents whose children had been infected with COVID-19 were more likely to have their children vaccinated. The most common reasons for vaccine hesitancy were "my child is not at high risk of COVID-19" (61%) and "I am afraid to put/inject a foreign object inside my child's body" (52.2%). Overall, vaccine acceptance was low among the parents of the children. Those parents with higher education, chronic illnesses, greater knowledge of COVID-19 and its vaccines, and those whose children had been infected with COVID-19 were significantly (p < 0.001) inclined towards vaccinating their children. Effective campaigns as well as awareness sessions are needed to address misinformation and reduce vaccine hesitancy.
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Affiliation(s)
- Zain Ul Harmain
- Department of Medicines, Tehsil Head Quarter (THQ) Hospital, Fortabbas 62020, Pakistan;
| | - Noorah A. Alkubaisi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Muhammad Hasnain
- Department of Medicine, Tehsil Head Quarter (THQ) Hospital, Kallurkot, Bhakkar 30000, Pakistan;
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan;
| | - Mohamed A. Baraka
- Department of Pharmacy, Fatima College of Health Sciences, Abu Dhabi 64141, United Arab Emirates
- Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo 11651, Egypt
| | - Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia; (Y.H.K.); (T.H.M.)
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia; (Y.H.K.); (T.H.M.)
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa; (J.C.M.); or (B.G.)
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa; (J.C.M.); or (B.G.)
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
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Karampatakis T, Tsergouli K, Roilides E. Infection control measures against multidrug-resistant Gram-negative bacteria in children and neonates. Future Microbiol 2023; 18:751-765. [PMID: 37584552 DOI: 10.2217/fmb-2023-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
The increase in infections caused by multidrug-resistant (MDR) Gram-negative bacteria in neonatal and pediatric intensive care units over recent years is alarming. MDR Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii have constituted the main causes of the MDR Gram-negative bacteria problem. The implementation of infection control measures such as hand hygiene, cohorting of patients, contact precautions, active surveillance and environmental cleaning could diminish their spread. Recently, water safety has been identified as a major component of infection control policies. The aim of the current review is to highlight the effectiveness of these infection control measures in managing outbreaks caused by MDR Gram-negative bacteria in neonatal and pediatric intensive care units and highlight future perspectives on the topic.
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Affiliation(s)
| | - Katerina Tsergouli
- Microbiology Department, Agios Pavlos General Hospital, Thessaloniki, 551 34, Greece
| | - Emmanuel Roilides
- Infectious Disease Unit, 3rd Department of Pediatrics, School of Health Sciences, Hippokration General Hospital, Thessaloniki, 546 42, Greece
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Gul B, Sana M, Saleem A, Mustafa ZU, Salman M, Khan YH, Mallhi TH, Sono TM, Meyer JC, Godman BB. Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan. Antibiotics (Basel) 2023; 12:1018. [PMID: 37370337 PMCID: PMC10294926 DOI: 10.3390/antibiotics12061018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Antibiotics are one of the most frequently dispensed classes of medicines. However, excessive misuse and abuse enhances antimicrobial resistance (AMR). Previous studies in Pakistan have documented extensive dispensing of 'Watch' and 'Reserve' antibiotics, which is a concern. In view of this, there is a need to assess current dispensing patterns following COVID-19 in Pakistan. A cross-sectional study was undertaken, collecting dispensing data from 39 pharmacies and 53 drug stores from November 2022 to February 2023. Outlets were principally in urban areas (60.9%), with pharmacists/pharmacy technicians present in 32.6% of outlets. In total, 11,092 prescriptions were analyzed; 67.1% of patients were supplied at least one antimicrobial, 74.3% antibiotics, 10.2% antifungals and 7.9% anthelmintics. A total of 33.2% of antimicrobials were supplied without a prescription. Common indications for dispensed antibiotics were respiratory (34.3%) and gastrointestinal (16.8%) infections, which can be self-limiting. In addition, 12% of antibiotics were dispensed for the prevention or treatment of COVID-19. The most frequent antibiotics dispensed were ceftriaxone (18.4%) and amoxicillin (15.4%). Overall, 59.2% antibiotics were 'Watch' antibiotics, followed by 'Access' (40.3%) and 'Reserve' (0.5%) antibiotics. Of the total antibiotics dispensed for treating COVID-19, 68.3% were 'Watch' and 31.7% 'Access'. Overall, there appeared to be an appreciable number of antibiotics dispensed during the recent pandemic, including for patients with COVID-19, alongside generally extensive dispensing of 'Watch' antibiotics. This needs to be urgently addressed with appropriate programs among pharmacists/pharmacy technicians to reduce AMR.
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Affiliation(s)
- Bushra Gul
- Department of Medicines, Tehsil Head Quarter (THQ) Hospital, District Bhakkar, Darya Khan 3000, Punjab, Pakistan;
| | - Maria Sana
- Department of Medicine, Faisalabad Medical University, Faisalabad 38000, Punjab, Pakistan; (M.S.); (A.S.)
| | - Aneela Saleem
- Department of Medicine, Faisalabad Medical University, Faisalabad 38000, Punjab, Pakistan; (M.S.); (A.S.)
| | - Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Punja, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Punja, Pakistan;
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia; (Y.H.K.); (T.H.M.)
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia; (Y.H.K.); (T.H.M.)
| | - Tiyani Milta Sono
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South Africa; (T.M.S.); (J.C.M.)
- Saselamani Pharmacy, Saselamani 0928, Limpopo, South Africa
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South Africa; (T.M.S.); (J.C.M.)
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South Africa
| | - Brian B. Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, Gauteng, South Africa; (T.M.S.); (J.C.M.)
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Hoxha I, Godman B, Malaj A, Meyer JC. 11-Year Trend in Antibiotic Consumption in a South-Eastern European Country; the Situation in Albania and the Implications for the Future. Antibiotics (Basel) 2023; 12:882. [PMID: 37237785 PMCID: PMC10215466 DOI: 10.3390/antibiotics12050882] [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: 03/31/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
There are growing concerns with rising antimicrobial resistance (AMR) across countries. These concerns are enhanced by the increasing and inappropriate utilization of 'Watch' antibiotics with their greater resistance potential, AMR is further exacerbated by the increasing use of antibiotics to treat patients with COVID-19 despite little evidence of bacterial infections. Currently, little is known about antibiotic utilization patterns in Albania in recent years, including the pandemic years, the influence of an ageing population, as well as increasing GDP and greater healthcare governance. Consequently, total utilization patterns in the country were tracked from 2011 to 2021 alongside key indicators. Key indicators included total utilization as well as changes in the use of 'Watch' antibiotics. Antibiotic consumption fell from 27.4 DIDs (defined daily doses per 1000 inhabitants per day) in 2011 to 18.8 DIDs in 2019, which was assisted by an ageing population and improved infrastructures. However, there was an appreciable increase in the use of 'Watch' antibiotics during the study period. Their utilization rose from 10% of the total utilization among the top 10 most utilized antibiotics (DID basis) in 2011 to 70% by 2019. Antibiotic utilization subsequently rose after the pandemic to 25.1 DIDs in 2021, reversing previous downward trends. Alongside this, there was increasing use of 'Watch' antibiotics, which accounted for 82% (DID basis) of the top 10 antibiotics in 2021. In conclusion, educational activities and antimicrobial stewardship programs are urgently needed in Albania to reduce inappropriate utilization, including 'Watch' antibiotics, and hence AMR.
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Affiliation(s)
- Iris Hoxha
- Department of Pharmacy, Faculty of Medicine, University of Medicine Tirana, 1001 Tirana, Albania
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
| | - Admir Malaj
- Independent Researcher, 1001 Tirana, Albania
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
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