Antimicrobial prescribing in referral hospitals in Timor-Leste: results of the first two national point prevalence surveys, 2020-21.

Autor:	Ximenes G; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Pharmacy Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste., Saha SK; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Infectious Diseases, Melbourne Medical School, National Centre for Antimicrobial Stewardship (NCAS), University of Melbourne, Melbourne, 3010 Victoria, Australia.; Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), IMPACT, Deakin University, Geelong 3220, VIC, Australia., Guterres H; Department of Internal Medicine, Hospital Nacional Guido Valadares, Dili, Timor-Leste., Vieira A; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste., Harris L; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste., Mahony M; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia., Dos Santos A; Pharmacy Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste., Toto L; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Internal Medicine, Hospital Nacional Guido Valadares, Dili, Timor-Leste., Amaral E; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Internal Medicine, Hospital Nacional Guido Valadares, Dili, Timor-Leste., Spargo JC; Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia., Tay SY; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Infectious Diseases, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia., Amaral S; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste., Champlin K; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste., Draper ADK; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Northern Territory Centre for Disease Control, Darwin 0810, Northern Territory, Australia.; National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra 0200, Australian Capital Territory, Australia., Francis JR; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia., Yan J; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia., Lynar SA; Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste.; Department of Infectious Diseases, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia.; Northern Territory Centre for Disease Control, Darwin 0810, Northern Territory, Australia.
Jazyk:	angličtina
Zdroj:	JAC-antimicrobial resistance [JAC Antimicrob Resist] 2024 Aug 01; Vol. 6 (4), pp. dlae123. Date of Electronic Publication: 2024 Aug 01 (Print Publication: 2024).
DOI:	10.1093/jacamr/dlae123
Abstrakt:	Objectives: To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste. Methods: In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients. Results: In 2020, 291/394 (73.9%) surveyed patients had been prescribed antimicrobials, compared with 260/403 (64.5%) in 2021 ( P  = 0.004). Most (309/551; 56.1%) were prescribed one antimicrobial, and 179/551 (32.5%) were prescribed two. The most commonly prescribed antibiotics were ceftriaxone (38.5% in 2020, 41.5% in 2021) and ampicillin (35.7% in 2020, 32.3% in 2021), followed by gentamicin, metronidazole and cloxacillin. Reserve antibiotics like meropenem and vancomycin were minimally used. Of all antimicrobial prescriptions, 70.8% were deemed appropriate in 2020 and 69.1% in 2021. Antimicrobial prescriptions for surgical and post-partum prophylaxis were frequently deemed inappropriate [37/50 (74.0%) and 39/44 (88.6%) prescriptions, respectively]. Conclusions: Most patients admitted to hospital in Timor-Leste are prescribed antimicrobials, and approximately one-third of these prescriptions are inappropriate. However, this was in the context of limited local guideline availability at the time of surveys and limited microbiological culture capacity outside of the capital, Dili. Improved microbiological guidance, iterative guideline revisions based on local antimicrobial resistance (AMR) surveillance data, and enhanced stewardship activities including further point prevalence studies, could improve antimicrobial use, optimize patient outcomes and reduce AMR in Timor-Leste. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
Databáze:	MEDLINE
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