ABSTRACT

Background

Rationale antibiotic use is crucial to address antimicrobial resistance (AMR) threats. No study has been undertaken in the Kurdistan Regional Government (KRG) to document current antibiotic use/areas for improvement given the high AMR rates.

Research design and methods

Point prevalence survey (PPS), using the Global PPS methodology, was conducted among the three major public hospitals in KRG/northern Iraq from September–December 2019. Prevalence and quality of antibiotic use were assessed using agreed indicators.

Results

Prevalence of antibiotic use was high (93.7%; n = 192/205); third-generation cephalosporins were the most commonly prescribed antibiotics (52.6%; n = 140/266). Reasons for treatment were recorded for only 61.7% (n = 164/266) of antibiotics and high use (89.9%) of parenteral therapy was observed. All therapy was empirical, no stop/review dates were recorded, and no treatment guidelines were available. The majority of the prescribed antibiotics (62%; n = 165/266) were from the WHO Watch list.

Conclusion

Prevalence of antibiotic use was high not only versus other hospitals in the region but globally, coupled with significant evidence of sub-optimal prescribing. Swift action is needed to improve future prescribing to reduce AMR. One or two areas should initially be targeted for quality improvement including development of local guidelines, documentation of antibiotic indications, and/or stop/review dates.

中文翻译：

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伊拉克北部库尔德斯坦地区政府医院抗生素处方和质量指标的多中心点流行率调查：需要采取紧急行动

摘要

背景

合理使用抗生素对于解决抗微生物药物耐药性 (AMR) 威胁至关重要。鉴于 AMR 率高，库尔德斯坦地区政府 (KRG) 尚未开展任何研究来记录当前的抗生素使用/需要改进的领域。

研究设计和方法

2019 年 9 月至 12 月，使用全球 PPS 方法在 KRG/伊拉克北部的三大公立医院中进行了点流行率调查 (PPS)。使用商定的指标评估了抗生素使用的流行率和质量。

结果

抗生素使用率很高（93.7%；n = 192/205）；第三代头孢菌素是最常用的抗生素（52.6%；n = 140/266）。仅 61.7% (n = 164/266) 的抗生素和胃肠外治疗的高使用率 (89.9%) 记录了治疗原因。所有治疗都是经验性的，没有记录停止/复查日期，也没有可用的治疗指南。大多数处方抗生素（62%；n = 165/266）来自世卫组织观察名单。

结论

不仅与该地区的其他医院相比，而且在全球范围内，抗生素使用的流行率都很高，而且有重要证据表明处方不理想。需要迅速采取行动来改进未来的处方以减少 AMR。最初应针对一两个领域进行质量改进，包括制定当地指南、记录抗生素适应症和/或停止/审查日期。