Point prevalence survey of antibiotic use in hospitals in Latin American countries
Authors: Levy Hara Gabriel , Rojas-Cortés Robin , Molina León Helvert Felipe , Dreser Mansilla Anahí , Alfonso Orta Ismary , Rizo-Amezquita José Noe , Santos Herrera René Guillermo , Mendoza de Ayala Silvia , Arce Villalobos Marlen , Mantilla Ponte Hilda , Davila Ever , Aguilar Gloria , Porrás Analía , Ramón-Pardo Pilar , Castro José Luis ,   on behalf of the Latin American Point Prevalent Survey Study Group, Guzmán Daniela , Rioseco María Luisa , Labarca Jaime , Madriz José Pablo Díaz , Cubero Josué Murillo , Calderón Allan Robles , Alfaro Mónica , Soto Luisa Arias , Aayon Alejandro , Oreamuno Tania Jiménez , Jiménez Zulema , Sequeira Adriana , Hernández Jorge Mederos , Lavaut Jorge Luis Campistrous , Meriño Damarys Castillo , Ruisanchez Elsa Fleitas , Sánchez Damaris Portuondo , Garcell Humberto Guanche , Socias Juan José Pisonero , Díaz Evelyn Perera , Lunar Norma America Cardoso , Lancis Irene Fiterre , Ramírez José Antonio Álvarez , Leyte Midsay López , Rosabal Ariadna Méndez , Estrada Ebel Aldana , Cano Mariela , Méndez Leonel , Eiriz Anay Cordero , Menéndez Liana Padrón , Fernández Gladys Fuentes , Ayala Raunel Reyes , Monroy Salomón , Menjívar Ramón , Martínez Carmen Elena Albanez , Cabrera Diana , Delgado Sofía Mercedes Menjivar , Guzmán Gustavo Antonio Molina , Mejía Rafael , Rodríguez Carolina , Alvarenga Sara , Alvarado Mirian , de Zelaya Ruth del Carmen Alvarado , Arévalo Germán , Parada Guillermo , Cuellar Luis , Ruiz Alexis Holguín , Pinedo Yuan Almora , Vergaray Eduardo Sánchez , Gil Luis Enrique Vasquez , Ibazeta Bertha Gizel Injante , Ricra Esther Dina Guadalupe , Segura Rony Estrada , Apac Coralith García , Inga Jennifer Cuadros , Díaz Roger Hernández , Vigo Marie Vallejo , Cuba Cesar Mujica , Vilcapoma Pierina , Angles-Yanqui Eddie , Terrones Débora Rocío Mananita , Robles Rosa Terán , Resurrección Cristhian , Gonzalez Alfredo Chiappe , Antezana Martha , Zegarra Socorro Torres , Villegas-Chiroque Miguel , Díaz-Sipión Roberto , Benítez-Peche Jorge , Rosas Jorge Luis Alave , Ruiz Jhoselyn Laura Goytizolo , Fernández Angélica María Hernández , Vargas José Antonio Flores , Araujo Javier , García Francisco Javier Arriaga , Rivera Zoila Cruz , Colín Víctor Monroy , Ríos Katia Bustamante , Blanquel Jorge Israel Hernández , de la Garza Eduardo Arias , Gutiérrez Héctor Hernández , León Karla , Lara Hortencia Esther Peralta , Arias Carlos Baltodano , Garay Eduardo Alemán , Sanabria Gladys Estigarribia , Menchaca Livio Mereles , Viré Natalia Luraschi , Acuña Dasy , Caballero Edgar Giménez 
Published: December 2021

Abstract

Background
Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals.

Methods
An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCap©) through a mobile device was used for data collection.

Results
Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6% received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3% of cases.

Conclusions
Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America.