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中东和北非地区(MENA)医院提高抗菌药物使用的现行策略:研究结果与启示

Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications.

作者信息

Haseeb Abdul, Saleem Zikria, Maqadmi Aseel Fayk, Allehyani Roaa Abdulrahman, Mahrous Ahmad J, Elrggal Mahmoud E, Kamran Sairah Hafeez, AlGethamy Manal, Naji Asem Saleh, AlQarni Abdullmoin, Alhariqi Khalid W, Khan Muhammad Arslan, Ibrahim Kiran, Raees Fahad, Azmat Aisha, Cook Aislinn, Campbell Stephen M, Lorenzetti Giulia, Meyer Johanna C, Godman Brian, Moore Catrin E

机构信息

Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia.

Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan.

出版信息

Antibiotics (Basel). 2023 Apr 28;12(5):827. doi: 10.3390/antibiotics12050827.

Abstract

Antimicrobial resistance (AMR) is an increasing global concern, increasing costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several global and national initiatives to slow down rising AMR rates. NAPs are also helping key stakeholders understand current antimicrobial utilization patterns and resistance rates. The Middle East is no exception, with high AMR rates. Antibiotic point prevalence surveys (PPS) provide a better understanding of existing antimicrobial consumption trends in hospitals and assist with the subsequent implementation of antimicrobial stewardship programs (ASPs). These are important NAP activities. We examined current hospital consumption trends across the Middle East along with documented ASPs. A narrative assessment of 24 PPS studies in the region found that, on average, more than 50% of in-patients received antibiotics, with Jordan having the highest rate of 98.1%. Published studies ranged in size from a single to 18 hospitals. The most prescribed antibiotics were ceftriaxone, metronidazole, and penicillin. In addition, significant postoperative antibiotic prescribing lasting up to five days or longer was common to avoid surgical site infections. These findings have resulted in a variety of suggested short-, medium-, and long-term actions among key stakeholders, including governments and healthcare workers, to improve and sustain future antibiotic prescribing in order to decrease AMR throughout the Middle East.

摘要

抗菌药物耐药性(AMR)是一个日益引起全球关注的问题,它会增加成本、发病率和死亡率。旨在将AMR降至最低的国家行动计划(NAPs)是全球和国家层面为减缓AMR发生率上升而采取的多项举措之一。NAPs还有助于关键利益相关者了解当前的抗菌药物使用模式和耐药率。中东地区也不例外,该地区的AMR率很高。抗生素现患率调查(PPS)有助于更好地了解医院现有的抗菌药物消费趋势,并有助于随后实施抗菌药物管理计划(ASPs)。这些都是NAP的重要活动。我们研究了中东地区当前的医院消费趋势以及已记录的ASPs。对该地区24项PPS研究的叙述性评估发现,平均而言,超过50%的住院患者接受了抗生素治疗,其中约旦的比例最高,为98.1%。已发表的研究规模从单一医院到18家医院不等。最常开具的抗生素是头孢曲松、甲硝唑和青霉素。此外,为避免手术部位感染,术后持续使用抗生素长达五天或更长时间的情况很常见。这些发现促使包括政府和医护人员在内的关键利益相关者提出了各种短期、中期和长期行动建议,以改善和维持未来的抗生素处方,从而降低整个中东地区的AMR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd2/10215537/5f1af5b98320/antibiotics-12-00827-g001.jpg

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