The Pattern of Antimicrobial Prescription at a Tertiary Health Center in Egypt: A Point Survey and Implications

Rehab H Ashour; Eman A Abdelkader; Omar Hamdy; Mohamed Elmetwally; Wafaa Laimon; Mohamed A Abd-Elaziz

doi:10.2147/IDR.S380693

The Pattern of Antimicrobial Prescription at a Tertiary Health Center in Egypt: A Point Survey and Implications

Infect Drug Resist. 2022 Oct 31:15:6365-6378. doi: 10.2147/IDR.S380693. eCollection 2022.

Authors

Rehab H Ashour^{1

2}, Eman A Abdelkader³, Omar Hamdy⁴, Mohamed Elmetwally⁴, Wafaa Laimon⁵, Mohamed A Abd-Elaziz¹

Affiliations

¹ Clinical Pharmacology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
² Pharmacology & Toxicology Department, Faculty of Medicine at Al-Qunfudah, Umm Al-Qura University, Al-Qunfudah, Kingdom of Saudi Arabia.
³ Internal Medicine Department, Faculty of Medicine, Mansoura University, Specialized Medical Hospital, Mansoura, Egypt.
⁴ Surgical Oncology Department, Faculty of Medicine, Oncology Center Mansoura University "OCMU", Mansoura, Egypt.
⁵ Pediatric Endocrinology and Diabetes Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura University Children's Hospital, Mansoura, Egypt.

Abstract

Background: The misuse of antimicrobials has major consequences, particularly antimicrobial resistance (AMR) and antimicrobials' related adverse effects. So, the WHO proposed antimicrobial surveillance to improve antimicrobials use. This point prevalence survey (PPS) was conducted to illustrate the prevalence of antimicrobial use at Mansoura University hospitals (MUH), Egypt.

Methods: The survey process used was adapted from the European survey of antimicrobial resistance with modifications. The survey was conducted from 8 AM to 8 PM daily within 2 weeks.

Results: A total of 300 patients received antimicrobials and the prevalence rate of antimicrobial prescription was 79.15%. The major indications of antimicrobials were surgical prophylaxis followed by the treatment of community-acquired infection. The most commonly prescribed initial antimicrobial group was Aminopenicillin ± β-lactamase inhibitors. Although the purpose for antimicrobial administration was recorded in all cases, the stop/review history was recorded only in 19.6% and local guidelines were not available for 77.6% of antimicrobial prescriptions. The use of combined antimicrobials was common (46.6%), particularly in orthopedic and cardiothoracic surgery.

Conclusion: The prevalence of antimicrobial prescription at MUH was high which requires serious actions including reviewing the antimicrobial indication, implementing local prescription guidelines, initiating an antimicrobial stewardship program (ASP), and optimizing infection control measures.

Keywords: Egypt; Mansoura; antimicrobial prescription pattern; point prevalence survey; quality indicators.

Grants and funding

This study was conducted as part of our routine work and did not receive any funds from funding agencies in the public, commercial, or not-for-profit sectors.