Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals.

Autor:	Jamaluddin NAH; Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.; Department of Hospital and Clinical Pharmacy, Faculty of Pharmacy, University of Cyberjaya, Cyberjaya, Selangor, Malaysia., Periyasamy P; Medical Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Lau CL; Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.; Pharmacy Department, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia., Ponnampalavanar S; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Lai PSM; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.; School of Medical and Life Sciences, Sunway University, Petaling Jaya, Selangor, Malaysia., Loong LS; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Tg Abu Bakar Sidik TMI; Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Ramli R; Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Tan TL; Emergency Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Kori N; Medical Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Yin MK; Pharmacy Department, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia., Azman NJ; Pharmacy Department, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia., James R; The Royal Melbourne Hospital, Melbourne, Australia.; National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, Melbourne, Australia., Thursky K; The Royal Melbourne Hospital, Melbourne, Australia.; National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, Melbourne, Australia., Naina Mohamed I; Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Jazyk:	angličtina
Zdroj:	Frontiers in pharmacology [Front Pharmacol] 2024 Apr 24; Vol. 15, pp. 1381843. Date of Electronic Publication: 2024 Apr 24 (Print Publication: 2024).
DOI:	10.3389/fphar.2024.1381843
Abstrakt:	Objectives: This study sought to investigate the quality of antimicrobial prescribing among adult surgical inpatients besides exploring the determinants of non-compliance and inappropriate prescribing to inform stewardship activities. Methods: A cross-sectional point prevalence study employing Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) was conducted in April 2019 at two teaching hospitals in Malaysia. Results: Among 566 surgical inpatients, 44.2% were receiving at least one antimicrobial, for a total of 339 prescriptions. Antimicrobials belonging to the World Health Organization's Watch group were observed in 57.8% of cases. Both hospitals exhibited similar types of antimicrobial treatments prescribed and administration routes. A significant difference in antimicrobial choice was observed between hospitals ( p < 0.001). Hospital with electronic prescribing demonstrated better documentation practice ( p < 0.001). Guidelines compliance, 32.8% ( p = 0.952) and appropriateness, 55.2% ( p = 0.561) did not significantly differ. The major contributors of inappropriateness were incorrect duration, (15%) and unnecessary broad-spectrum coverage, (15.6%). Non-compliance and inappropriate prescribing were found to be 2 to 4 times significantly higher with antimicrobial prophylaxis prescription compared to empirical therapy. Conclusion: Antimicrobial stewardship efforts to improve appropriate surgical prescribing are essential. These initiatives should prioritize surgical prophylaxis prescribing, focusing on reducing unnecessarily prolonged use and broad-spectrum antimicrobials, raising awareness among prescribers and promoting proper documentation. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Jamaluddin, Periyasamy, Lau, Ponnampalavanar, Lai, Loong, Tg Abu Bakar Sidik, Ramli, Tan, Kori, Yin, Azman, James, Thursky and Naina Mohamed.)
Databáze:	MEDLINE
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