A Longitudinal Study of Point Prevalence of Antimicrobial Use and Resistance in Ahvaz Hospitals in 2020 - 2021: A Multicenter Study

Abstract

Background: Excessive prescription of antibiotics is the main factor contributing to the emergence of resistant bacteria. Objectives: To complement the global research conducted by Belgium's Antrop University and the World Health Organization (WHO) in Iran, this study aimed to evaluate the prevalence of antibiotic prescriptions in Ahvaz hospitals. Methods: This was a descriptive longitudinal study. The statistical population consisted of all patients hospitalized at Imam Khomeini, Golestan, and Abuzar Hospitals in Ahvaz between 2020 and 2021 (2035 patients). The data collection tool was a checklist from the educational department and special care department, completed by clinical assistants and recorded in the Global Point Prevalence online software. Data analysis was performed using SPSS version 22. Results: The overall prevalence of antimicrobial use in Golestan, Imam Khomeini, and Abuzar Hospitals was reported as 43.2%, 44.1%, and 57.9%, respectively. The most common antibiotics for treating sepsis in both adults and children were vancomycin and meropenem. The most commonly used antibiotics for treating upper and lower urinary tract infections (UTIs) and for surgical prophylaxis were ceftriaxone and meropenem. Meropenem was the most commonly used antibiotic for treating pneumonia. The highest rates of antimicrobial resistance were reported for cefazolin (81.42%), ampicillin (93.77%), and ampicillin (94.02%) in Golestan, Imam Khomeini, and Abuzar Hospitals, respectively. The lowest rates of antimicrobial resistance were reported for ciprofloxacin (18.57%) in Golestan Hospital, ciprofloxacin (15.58%) in Imam Khomeini Hospital, and piperacillin/tazobactam (12.04%) in Abuzar Hospital. Conclusions: Due to the high consumption of ceftriaxone and the significant resistance to ampicillin and cefazolin, continuous monitoring is essential to adjust antibiotic usage and resistance patterns in local, provincial, and national referral hospitals.