Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital.
OBJECTIVE
Inappropriate antimicrobial use can promote antimicrobial resistance, which is associated with increased patient morbidity and mortality. Identifying the pattern of antimicrobial use can provide data from which targeted antimicrobial stewardship interventions can be made. The primary objective was to identify the prevalence of antimicrobial use at a tertiary care teaching hospital with both acute and long-term care patients.


METHODS
A point prevalence study was conducted on July 19th, 2012. Data on antimicrobial utilization, indication for prescribing, duration of therapy, and frequency of infectious disease or antimicrobial stewardship consultations were collected using a customized integrated stewardship database (SPIRIT) and prospective chart review.


RESULTS
One or more antimicrobial agents were ordered in 31% and 4% of acute care and long-term care patients, respectively. Respiratory and urinary tract infections were the most common indication for antimicrobial therapy in both acute and long-term care. About 25% of surgical prophylaxis orders were prescribed for greater than 24h.


CONCLUSIONS
This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.
Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Leslie L. Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Colin
C
Lee
Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Leslie L. Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada; Department of Microbiology and Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Sandra A N
SA
Walker
Department of Microbiology and Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Nick
N
Daneman
Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Marion
M
Elligsen
Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Lesley
L
Palmay
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Bryan
B
Coburn
Department of Microbiology and Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Andrew
A
Simor
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002170:Canada; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review / Q000379:methods*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
D000890:Anti-Infective Agents
Acute care; Long-term care; Prospective; Surveillance