BACKGROUND The inappropriate use of antimicrobials and increased rates of antimicrobial resistance is a challenge all over the world. Although antibiotic stewardship is recommended by the Brazilian government, data regarding antibiotic use in Brazilian hospitals are scarce. The aim of this study was to conduct a point prevalence survey of antimicrobial use in 18 Brazilian hospitals. METHODS Eighteen Brazilian hospitals conducted the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) in 2017. The study enrolled inpatients on antimicrobials. Data collection included details on the antimicrobial prescriptions. A web-based programme was used for data-entry, validation and reporting. The Global-PPS was developed by the University of Antwerp and bioMérieux provided funding support. FINDINGS A total of 1801 patients were evaluated, of which 941 (52.2%) were on antimicrobials. Four hundred (42.5%) patients were given at least two antimicrobials. Out of the 1317 antibacterials for systemic use, 514 (39%) were prescribed for community-acquired infections, 533 (40.5%) for healthcare-associated infections and 248 (18.8%) for prophylactic use. The most frequently used antimicrobials were ceftriaxone (12.8%), meropenem (12.3%) and vancomycin (10.3%). Pneumonia or lower respiratory tract infection was the most common site of infection (29.2%). In general, antimicrobials were given mainly parenterally (91%) and empirically (81.2%). CONCLUSIONS A high prevalence of antibiotic use was observed in the 18 Brazilian hospitals. The antibiotics were prescribed mainly empirically. Intravenous broad-spectrum antibiotics were the most frequent antimicrobials used, showing that reinforcement of de-escalation strategy is needed. The Global-PPS data can be very useful for monitoring stewardship programmes and intervention.

中文翻译：

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巴西医院抗菌药物消费的全球总体流行率调查。

背景技术不适当地使用抗微生物剂和增加的抗微生物剂耐药率是全世界的挑战。尽管巴西政府建议进行抗生素管理，但有关巴西医院使用抗生素的数据很少。这项研究的目的是对18家巴西医院的抗菌药物使用进行点流行度调查。方法2017年，巴西的18所医院进行了全球抗菌药物消费和耐药点流行度调查（Global-PPS）。该研究招募了住院患者进行抗菌药物治疗。数据收集包括有关抗菌药物处方的详细信息。基于Web的程序用于数据输入，验证和报告。Global-PPS由安特卫普大学开发，bioMérieux提供了资金支持。研究结果共评估了1801例患者，其中941例（52.2％）接受了抗菌药物治疗。四百（42.5％）名患者至少接受了两种抗菌药物治疗。在用于全身性使用的1317种抗菌剂中，有514种（39％）被处方用于社区获得性感染，533种（40.5％）用于医疗保健相关感染，248种（18.8％）用于预防性使用。最常用的抗菌药物是头孢曲松（12.8％），美罗培南（12.3％）和万古霉素（10.3％）。肺炎或下呼吸道感染是最常见的感染部位（29.2％）。通常，抗菌药物主要通过肠胃外给药（91％）和根据经验（81.2％）给药。结论在巴西的18家医院中，抗生素使用率很高。抗生素主要是凭经验开的。静脉使用广谱抗生素是最常用的抗菌药物，表明需要加强降级策略。Global-PPS数据对于监控管理计划和干预非常有用。