ANTIBIOTIC POINT PREVALENCE SURVEY DURING THE PANDEMIC IN A COVID-19 DESIGNATED HOSPITAL IN MALAYSIA

Abstract

Intro: Recent reports have shown that antibiotics were commonly prescribed in COVID-19 designated hospitals throughout the pandemic in spite of it being ineffective in treating viruses such as SARS-COV 2 which is the pathogen responsible for causing COVID-19. Methods: We conducted a cross-sectional Point Prevalence Survey (PPS) involving all wards in Hospital Sungai Buloh. Each ward was audited within one day within the period of two weeks (1st December 2021 till 14th December 2021). All in-patients receiving IV or oral antibiotics at 8am on the day of survey were included in the study. Findings: A total of 200 out of 664 in-patients (30%) were treated with antibiotics during the study period. COVID ICU recorded the highest prevalence of patient on antibiotics (83%) followed by General Medical (43%). Majority of patients received antibiotics for empirical therapy (80%, 160/200) and community-acquired pneumonia was the most common indication documented (36.5%, 75/205), followed by hospital-acquired pneumonia, with 23.4% of total documented indication (48/205). We found that in half of the patients (104/200), clinicians did not document the indication of antibiotic. Rate of prescription that was compliant to guideline was higher than that of non-compliant to guideline from total of 139 cases recorded (68% vs 32%). We found that there was a significant association between rate of compliant to guideline with respiratory diseases (χ² = 5.37, p<0.05). Twenty-seven percent of patients received antibiotics for respiratory diseases not according to guideline recommendation. Majority of cases of non-compliance to guideline, were patient with respiratory diseases (58.7%, 27 out of 46 cases). Conclusion: This pandemic has had an impact on the use of antibiotics, where its use has been found to increase drastically, especially in critical and severe patients. This high use makes adherence to the guidelines become important and should be an ongoing indicator, also it can be used as a guide for antimicrobial stewardship intervention.