TY - JOUR
T1 - Antimicrobial prescribing in referral hospitals in Timor-Leste
T2 - results of the first two national point prevalence surveys, 2020-21
AU - Ximenes, Guilherme
AU - Saha, Sajal K.
AU - Guterres, Helio
AU - Vieira, Adriano
AU - Harris, Lisa
AU - Mahony, Michelle
AU - Santos, Agata Dos
AU - Toto, Lucia
AU - Amaral, Elfiana
AU - Spargo, Jessie C.
AU - Tay, Sze Yen
AU - Amaral, Salvador
AU - Champlin, Karen
AU - Draper, Anthony D.K.
AU - Francis, Joshua R.
AU - Yan, Jennifer
AU - Lynar, Sarah A.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/8/1
Y1 - 2024/8/1
N2 - Objectives: To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste. Methods: In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients. Results: In 2020, 291/394 (73.9%) surveyed patients had been prescribed antimicrobials, compared with 260/403 (64.5%) in 2021 (P= 0.004). Most (309/551; 56.1%) were prescribed one antimicrobial, and 179/551 (32.5%) were prescribed two. The most commonly prescribed antibiotics were ceftriaxone (38.5% in 2020, 41.5% in 2021) and ampicillin (35.7% in 2020, 32.3% in 2021), followed by gentamicin, metronidazole and cloxacillin. Reserve antibiotics like meropenem and vancomycin were minimally used. Of all antimicrobial prescriptions, 70.8% were deemed appropriate in 2020 and 69.1% in 2021. Antimicrobial prescriptions for surgical and post-partum prophylaxis were frequently deemed inappropriate [37/50 (74.0%) and 39/44 (88.6%) prescriptions, respectively]. Conclusions: Most patients admitted to hospital in Timor-Leste are prescribed antimicrobials, and approximately one-third of these prescriptions are inappropriate. However, this was in the context of limited local guideline availability at the time of surveys and limited microbiological culture capacity outside of the capital, Dili. Improved microbiological guidance, iterative guideline revisions based on local antimicrobial resistance (AMR) surveillance data, and enhanced stewardship activities including further point prevalence studies, could improve antimicrobial use, optimize patient outcomes and reduce AMR in Timor-Leste.
AB - Objectives: To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste. Methods: In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients. Results: In 2020, 291/394 (73.9%) surveyed patients had been prescribed antimicrobials, compared with 260/403 (64.5%) in 2021 (P= 0.004). Most (309/551; 56.1%) were prescribed one antimicrobial, and 179/551 (32.5%) were prescribed two. The most commonly prescribed antibiotics were ceftriaxone (38.5% in 2020, 41.5% in 2021) and ampicillin (35.7% in 2020, 32.3% in 2021), followed by gentamicin, metronidazole and cloxacillin. Reserve antibiotics like meropenem and vancomycin were minimally used. Of all antimicrobial prescriptions, 70.8% were deemed appropriate in 2020 and 69.1% in 2021. Antimicrobial prescriptions for surgical and post-partum prophylaxis were frequently deemed inappropriate [37/50 (74.0%) and 39/44 (88.6%) prescriptions, respectively]. Conclusions: Most patients admitted to hospital in Timor-Leste are prescribed antimicrobials, and approximately one-third of these prescriptions are inappropriate. However, this was in the context of limited local guideline availability at the time of surveys and limited microbiological culture capacity outside of the capital, Dili. Improved microbiological guidance, iterative guideline revisions based on local antimicrobial resistance (AMR) surveillance data, and enhanced stewardship activities including further point prevalence studies, could improve antimicrobial use, optimize patient outcomes and reduce AMR in Timor-Leste.
UR - http://www.scopus.com/inward/record.url?scp=85200566548&partnerID=8YFLogxK
U2 - 10.1093/jacamr/dlae123
DO - 10.1093/jacamr/dlae123
M3 - Article
AN - SCOPUS:85200566548
SN - 2632-1823
VL - 6
SP - 1
EP - 10
JO - JAC-Antimicrobial Resistance
JF - JAC-Antimicrobial Resistance
IS - 4
M1 - dlae123
ER -
