Zumaya-Estrada Federico A, Ponce-de-León-Garduño Alfredo, Ortiz-Brizuela Edgar, Tinoco-Favila Juan Carlos, Cornejo-Juárez Patricia, Vilar-Compte Diana, Sassoé-González Alejandro, Saturno-Hernandez Pedro Jesus, Alpuche-Aranda Celia M
Center for Infectious Diseases Research (CISEI), National Institute of Public Health (INSP), Cuernavaca, C.P. 62100, Morelos, México.
Infectology Department, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Ciudad de México, C.P. 14080, México.
Infect Drug Resist. 2021 Nov 2;14:4553-4566. doi: 10.2147/IDR.S327721. eCollection 2021.
To describe the antimicrobial use in four tertiary care hospitals in Mexico.
Point prevalence surveys (PPSs) were conducted on medical records of hospitalized patients with prescribed antimicrobials (AMs) in four tertiary care hospitals in Mexico in 2019. Prevalence estimates and descriptive statistics were used to present the collected data on antimicrobial prescribing and microbiological studies.
The prevalence of patients with prescribed AMs among the hospitals ranged from 47.1% to 91.3%. Antibiotics for systemic use (J01s) were the most prescribed (84.6%, [95% CI: 81.5-87.3]), mainly extended-spectrum J01s: third-generation cephalosporins 19.8% [95% CI: 16.8-23.1], and carbapenems 17.0% [95% CI: 14.2-20.2]. Antibiotic treatments were largely empirical, with no planned duration or review dates. The ceftriaxone use was excessive and prolonged. No formal reference guidelines for antimicrobial prescribing were available in the hospitals. Multidrug-resistant and ESKAPE pathogens were identified in all hospitals.
This study describes the extensive use of antimicrobials and broad-spectrum antibiotics for systemic use in Mexican hospitals, along with the presence of resistant pathogens to the antibiotics frequently used in the hospitals surveyed.
描述墨西哥四家三级医疗机构的抗菌药物使用情况。
2019年，对墨西哥四家三级医疗机构中使用抗菌药物（AMs）的住院患者病历进行了现患率调查（PPSs）。采用现患率估计值和描述性统计方法来呈现所收集的抗菌药物处方和微生物学研究数据。
各医院中使用抗菌药物的患者现患率在47.1%至91.3%之间。全身用抗生素（J01s）的处方量最大（84.6%，[95%置信区间：81.5 - 87.3]），主要是广谱J01s：第三代头孢菌素19.8% [95%置信区间：16.8 - 23.1]，碳青霉烯类17.0% [95%置信区间：14.2 - 20.2]。抗生素治疗大多是经验性的，没有计划的疗程或复查日期。头孢曲松的使用过量且疗程延长。各医院均没有正式的抗菌药物处方参考指南。在所有医院均发现了多重耐药菌和ESKAPE病原体。
本研究描述了墨西哥医院中全身用抗菌药物和广谱抗生素的广泛使用情况，以及在所调查医院中存在对常用抗生素耐药的病原体。
