Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 19, Issue 6, Pages 805-814Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2021.1834852
Keywords
Antimicrobial resistance; antibiotic utilization patterns; iraq; kurdistan regional government; point prevalence survey; quality improvement programs
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The high prevalence of antibiotic use in hospitals in the Kurdistan Regional Government (KRG) highlights the need for improved prescribing practices, such as documenting treatment indications and developing treatment guidelines.
Background Rationale antibiotic use is crucial to address antimicrobial resistance (AMR) threats. No study has been undertaken in the Kurdistan Regional Government (KRG) to document current antibiotic use/areas for improvement given the high AMR rates. Research design and methods Point prevalence survey (PPS), using the Global PPS methodology, was conducted among the three major public hospitals in KRG/northern Iraq from September-December 2019. Prevalence and quality of antibiotic use were assessed using agreed indicators. Results Prevalence of antibiotic use was high (93.7%; n = 192/205); third-generation cephalosporins were the most commonly prescribed antibiotics (52.6%; n = 140/266). Reasons for treatment were recorded for only 61.7% (n = 164/266) of antibiotics and high use (89.9%) of parenteral therapy was observed. All therapy was empirical, no stop/review dates were recorded, and no treatment guidelines were available. The majority of the prescribed antibiotics (62%; n = 165/266) were from the WHO Watch list. Conclusion Prevalence of antibiotic use was high not only versus other hospitals in the region but globally, coupled with significant evidence of sub-optimal prescribing. Swift action is needed to improve future prescribing to reduce AMR. One or two areas should initially be targeted for quality improvement including development of local guidelines, documentation of antibiotic indications, and/or stop/review dates.
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