Frontiers in Pharmacology (Apr 2024)

Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals

  • Nurul Adilla Hayat Jamaluddin,
  • Nurul Adilla Hayat Jamaluddin,
  • Petrick Periyasamy,
  • Chee Lan Lau,
  • Chee Lan Lau,
  • Sasheela Ponnampalavanar,
  • Pauline Siew Mei Lai,
  • Pauline Siew Mei Lai,
  • Ly Sia Loong,
  • Tg Mohd Ikhwan Tg Abu Bakar Sidik,
  • Ramliza Ramli,
  • Toh Leong Tan,
  • Najma Kori,
  • Mei Kuen Yin,
  • Nur Jannah Azman,
  • Rodney James,
  • Rodney James,
  • Karin Thursky,
  • Karin Thursky,
  • Isa Naina Mohamed

DOI
https://doi.org/10.3389/fphar.2024.1381843
Journal volume & issue
Vol. 15

Abstract

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Objectives: This study sought to investigate the quality of antimicrobial prescribing among adult surgical inpatients besides exploring the determinants of non-compliance and inappropriate prescribing to inform stewardship activities.Methods: A cross-sectional point prevalence study employing Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) was conducted in April 2019 at two teaching hospitals in Malaysia.Results: Among 566 surgical inpatients, 44.2% were receiving at least one antimicrobial, for a total of 339 prescriptions. Antimicrobials belonging to the World Health Organization’s Watch group were observed in 57.8% of cases. Both hospitals exhibited similar types of antimicrobial treatments prescribed and administration routes. A significant difference in antimicrobial choice was observed between hospitals (p < 0.001). Hospital with electronic prescribing demonstrated better documentation practice (p < 0.001). Guidelines compliance, 32.8% (p = 0.952) and appropriateness, 55.2% (p = 0.561) did not significantly differ. The major contributors of inappropriateness were incorrect duration, (15%) and unnecessary broad-spectrum coverage, (15.6%). Non-compliance and inappropriate prescribing were found to be 2 to 4 times significantly higher with antimicrobial prophylaxis prescription compared to empirical therapy.Conclusion: Antimicrobial stewardship efforts to improve appropriate surgical prescribing are essential. These initiatives should prioritize surgical prophylaxis prescribing, focusing on reducing unnecessarily prolonged use and broad-spectrum antimicrobials, raising awareness among prescribers and promoting proper documentation.

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