McGill University Health Center, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.
Faculty of Pharmacy, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, Quebec, H3T 1J4, Canada.
Antimicrob Resist Infect Control. 2020 Jul 11;9(1):104. doi: 10.1186/s13756-020-00758-x.
Patient-level surveillance (indication, appropriate choice, dosing, route, duration) of antimicrobial use in Canadian hospitals is needed to reduce antimicrobial overuse and misuse. Patient-level surveillance has not been performed on a national level in Canada. The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) is an international collaborative to monitor antimicrobial use and resistance in hospitals worldwide. Global-PPS locally documents on a single day patient-level antimicrobial prescribing practices. This article presents the results of the 2017 Global-PPS in Canadian hospitals with established antimicrobial stewardship programs.
Hospitals part of the Canadian Nosocomial Infection Surveillance Program were invited to participate. Surveys could be performed any time in the 2017 calendar year. All in-patient wards in each hospital were surveyed by a physician, pharmacist or nurse with infectious disease training.
Fourteen Canadian hospitals participated in the survey. Of 4118 patients, 1400 patients (34.0%) received a total of 2041 antimicrobials. Overall, 73.1% (n = 1493) of antimicrobials were for therapeutic use, 14.2% (n = 288) were for medical prophylaxis, 8.3% (n = 170) were for surgical prophylaxis, 1.8% (n = 37) were for other reasons, and 0.2% (n = 3) were used as prokinetic agents. Only 2.5% (n = 50) were for unknown reasons. For antimicrobials for therapeutic use, 29.9% of patients were treated for lower respiratory tract (343/1147), 10.5% for intra-abdominal (120/1147), 9.3% for skin and soft tissue (107/1147) and 7.5% for gastro-intestinal (86/1147) infections.
Standardized methodology amongst Global-PPSs allows the comparison of our results to the 2015 Global-PPS. The prevalence of antimicrobial use on medical, surgical, and intensive care wards are similar to those previously observed in North America. Indication of antimicrobials has not been previously reported on such a large scale in Canadian hospitals. This report serves as a comparison for further point prevalence surveys that are currently underway. It will be used for identifying opportunities and benchmarking in antibiotic stewardship.
为了减少抗菌药物的过度使用和滥用，需要对加拿大医院的抗菌药物使用情况（适应证、合理选择、剂量、给药途径、疗程）进行以患者为基础的监测。在加拿大，尚未在全国范围内开展以患者为基础的监测工作。全球抗菌药物消耗和耐药性点患病率调查（Global-PPS）是一项国际合作项目，旨在监测全球医院的抗菌药物使用和耐药情况。Global-PPS 可在当地的某一天记录患者的抗菌药物处方实践。本文介绍了在已建立抗菌药物管理计划的加拿大医院进行的 2017 年全球抗菌药物消耗和耐药性调查（Global-PPS）的结果。
邀请参加加拿大医院感染监测计划的医院参加。调查可在 2017 年日历年的任何时间进行。每家医院的所有住院病房都由具有传染病培训的医生、药剂师或护士进行调查。
14 家加拿大医院参加了调查。在 4118 名患者中，1400 名患者（34.0%）共接受了 2041 种抗菌药物治疗。总体而言，73.1%（n=1493）的抗菌药物用于治疗，14.2%（n=288）用于医疗预防，8.3%（n=170）用于手术预防，1.8%（n=37）用于其他原因，0.2%（n=3）用于促进蠕动。只有 2.5%（n=50）是不明原因的。对于治疗用抗菌药物，29.9%的患者因下呼吸道（343/1147）感染而接受治疗，10.5%因腹腔内（120/1147）感染而接受治疗，9.3%因皮肤和软组织（107/1147）感染而接受治疗，7.5%因胃肠道（86/1147）感染而接受治疗。
全球点患病率调查之间的标准化方法使我们可以将结果与 2015 年全球点患病率调查进行比较。医疗、外科和重症监护病房抗菌药物使用的流行率与以前在北美观察到的流行率相似。以前没有在如此大的范围内报告过加拿大医院抗菌药物的适应证。本报告可作为目前正在进行的进一步点患病率调查的比较。它将用于确定抗生素管理方面的机会和基准。
