Point Prevalence Survey of Antimicrobial Use in Four Tertiary Care Hospitals in Mexico

Abstract

Federico A Zumaya-Estrada,1 Alfredo Ponce-de-León-Garduño,2 Edgar Ortiz-Brizuela,2 Juan Carlos Tinoco-Favila,3 Patricia Cornejo-Juárez,4 Diana Vilar-Compte,4 Alejandro Sassoé-González,5 Pedro Jesus Saturno-Hernandez,6 Celia M Alpuche-Aranda1 1Center for Infectious Diseases Research (CISEI), National Institute of Public Health (INSP), Cuernavaca, C.P. 62100, Morelos, México; 2Infectology Department, National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, Ciudad de México, C.P. 14080, México; 3Infectology Department, Hospital General 450, Secretary of Health of Durango, Durango, C.P. 34206, Durango, México; 4Infectious Diseases Department, National Institute of Cancer (INCan), Ciudad de México, C.P. 14080, México; 5Epidemiological Intelligence Unit, High Specialty Regional Hospital of Ixtapaluca, Estado de México, C.P. 56530, México; 6Center for Evaluation and Surveys Research (CIEE), National Institute of Public Health (INSP), Cuernavaca, C.P. 62100, Morelos, MéxicoCorrespondence: Celia M Alpuche-ArandaCenter for Infectious Diseases Research (CISEI), National Institute of Public Health (INSP), Cuernavaca, C.P. 62100, Morelos, MéxicoTel [phone] ext. 2101Email [email protected] Jesus Saturno-HernandezCenter for Evaluation and Surveys Research (CIEE), National Institute of Public Health (INSP), Cuernavaca, C.P. 62100, Morelos, MéxicoTel [phone] ext. 4332Email [email protected]: To describe the antimicrobial use in four tertiary care hospitals in Mexico.Patients and Methods: Point prevalence surveys (PPSs) were conducted on medical records of hospitalized patients with prescribed antimicrobials (AMs) in four tertiary care hospitals in Mexico in 2019. Prevalence estimates and descriptive statistics were used to present the collected data on antimicrobial prescribing and microbiological studies.Results: The prevalence of patients with prescribed AMs among the hospitals ranged from 47.1% to 91.3%. Antibiotics for systemic use (J01s) were the most prescribed (84.6%, [95% CI: 81.5– 87.3]), mainly extended-spectrum J01s: third-generation cephalosporins 19.8% [95% CI: 16.8– 23.1], and carbapenems 17.0% [95% CI: 14.2– 20.2]. Antibiotic treatments were largely empirical, with no planned duration or review dates. The ceftriaxone use was excessive and prolonged. No formal reference guidelines for antimicrobial prescribing were available in the hospitals. Multidrug-resistant Escherichia coli and ESKAPE pathogens were identified in all hospitals.Conclusion: This study describes the extensive use of antimicrobials and broad-spectrum antibiotics for systemic use in Mexican hospitals, along with the presence of resistant pathogens to the antibiotics frequently used in the hospitals surveyed.Keywords: PPSs, antimicrobial use, antibiotics, Mexican hospitals

Keywords

• ppss
• antimicrobial use
• antibiotics
• mexican hospitals.