Hospital Durand, Buenos Aires, Argentina.
Pan American Health Organization/World Health Organization, Washington, DC, USA.
J Antimicrob Chemother. 2022 Feb 23;77(3):807-815. doi: 10.1093/jac/dkab459.
Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals.
An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCap©) through a mobile device was used for data collection.
Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6% received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3% of cases.
Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America.
抗生素使用时点患病率调查（PPS）有助于了解与医院处方模式相关的不同方面。
采用世界卫生组织（WHO）抗生素使用 PPS 方法进行改编。将医院病房分为内科（MED）、外科（SUR）、重症监护病房（ICU）、妇产科（GO）、高风险（HR）和混合病房（MIX）。通过移动设备上的网络应用程序（RedCap©）进行数据收集。
2018 年 12 月至 2019 年 8 月，来自五个国家 33 家医院的 5444 名患者被纳入研究（古巴 10 家医院、巴拉圭 7 家、萨尔瓦多 6 家、墨西哥 5 家、秘鲁 5 家）。这些患者中，54.6%至少接受了一种抗生素治疗，不同医院和国家之间存在差异。抗生素在 ICU（67.2%）、SUR（64.5%）和 MED 病房（54.2%）中使用更为频繁，其中 51.2%的抗生素用于治疗社区获得性感染（CAI），22.9%用于治疗医源性感染（HAI），11.1%用于手术预防，6.1%的原因不明。在 68.6%的病例中观察到了指南的依从性（CAI 为 72.8%，HAI 为 72.4%，预防为 44.3%）。第三代头孢菌素是使用最广泛的抗生素类别（26.8%），其次是碳青霉烯类（10.3%）和氟喹诺酮类（8%）。在 17.3%的病例中实现了靶向治疗。
抗生素的使用总体上高于其他研究报告的水平。拉丁美洲迫切需要推广和加强抗菌药物管理计划。
