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. 2023 Jan 4;5(1):dlac140.
doi: 10.1093/jacamr/dlac140. eCollection 2023 Feb.

Point prevalence survey of antibiotic use among hospitalized patients across 41 hospitals in Thailand

Suvaporn Anugulruengkitt  1   2 , Lantharita Charoenpong  3 , Anond Kulthanmanusorn  4 , Varaporn Thienthong  5 , Sang Usayaporn  6 , Wanwisa Kaewkhankhaeng  4 , Oranat Rueangna  4 , Jiratchaya Sophonphan  7 , Visal Moolasart  3 , Weerawat Manosuthi  3 , Viroj Tangcharoensathien  4
Affiliations

Point prevalence survey of antibiotic use among hospitalized patients across 41 hospitals in Thailand

Suvaporn Anugulruengkitt et al. JAC Antimicrob Resist. .

Abstract

Objectives: To describe the antibiotic use among hospitalized patients in Thailand.

Methods: A standardized cross-sectional point prevalence survey (PPS) modified from the WHO PPS protocol was conducted in 41 selected hospitals in Thailand. All inpatients who received an antibiotic at 9 a.m. on the survey date were enrolled. The total number of inpatients on that day was the denominator.

Results: Between March and May 2021, a total of 8958 inpatients were enumerated; 4745 inpatients received antibiotics on the day of the survey and there were 6619 prescriptions of antibiotics. The prevalence of antibiotic use was 53.0% (95% CI 51.1%-54.0%), ranging from 14.3% to 73.4%. The antibiotic use was highest among adults aged >65 years (57.1%; 95% CI 55.3%-58.9%). From 6619 antibiotics prescribed, 68.6% were used to treat infection, 26.7% for prophylaxis and 4.7% for other or unknown indications. Overall, the top three commonly used antibiotics were third-generation cephalosporins (1993; 30.1%), followed by first-generation cephalosporins (737; 11.1%) and carbapenems (703; 10.6%). The most frequently used antibiotics for community-acquired infections were third-generation cephalosporins (36.8%), followed by β-lactam/β-lactamase inhibitors (11.8%) and carbapenems (11.3%) whereas for the patients with hospital-acquired infections, the most common antibiotics used were carbapenems (32.7%), followed by β-lactam/β-lactamase inhibitors (15.7%), third-generation cephalosporins (11.7%) and colistin (11.7%). The first-generation cephalosporins were the most commonly used antibiotics (37.7%) for surgical prophylaxis. Seventy percent of the patients received surgical prophylaxis for more than 1 day post surgery.

Conclusions: The prevalence of antibiotic use among hospitalized patients in Thailand is high and one-quarter of these antibiotics were used for prophylaxis. The majority of surgical prophylaxis was inappropriately used for a long duration post operation. Therefore, it is recommended that local guidelines should be developed and implemented.

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Figures

Figure 1.
Figure 1.
Prevalence of antibiotic use categorized according to the levels of the hospitals (overall P value <0.001).
Figure 2.
Figure 2.
Percentages of 6619 antibiotic prescriptions.
Figure 3.
Figure 3.
Proportional consumption (%) of antibiotic by WHO AWaRe classification stratified by the level of the hospitals.
Figure 4.
Figure 4.
Proportion of antibiotic use stratified by indication.
Figure 5.
Figure 5.
Duration of antibiotic use for surgical prophylaxis. SSTBJ, skin, soft tissue, bone and joint; GI, gastrointestinal tract; GO, gynaecology and obstetrics; UTI, urinary tract; EYE, ophthalmic; ENT, otolaryngology; CVS, cardiovascular system; RESP, respiratory tract.
Figure 6.
Figure 6.
Prevalence of HAIs and 95% CI according to the level of the hospitals (overall P value <0.001).
See this image and copyright information in PMC

References

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