title: Point prevalence study of antimicrobial usage in acute care hospitals in the Slovak Republic.
abstract: BACKGROUND
  Antimicrobial use and resultant resistance is still increasing worldwide. Close monitoring and strict implementation of policies are important to tackle this issue.
  
  
  OBJECTIVE
  To assess the use of antimicrobials in acute care hospitals in the Slovak Republic.
  
  
  METHODS
  Antimicrobial use was monitored as part of a point prevalence survey (PPS) of healthcare-associated infections. Surveillance was performed in 40 hospitals in the Slovak Republic according to the standardized methodology developed by the European Centre for Disease Prevention and Control. Data were collected according to a standard protocol.
  
  
  RESULTS
  In total, 8397 patients in 40 Slovak hospitals were surveyed. Of these, 30.7% were receiving antibiotics at the time of the survey. In 630 cases, patients were receiving more than one antimicrobial agent. The prevalence of antimicrobial use was highest in intensive care units (54.3%). Antimicrobials were prescribed most frequently for treatment of community-acquired infections (48.1%) and healthcare-associated infections (11.4%). Surgical prophylaxis was the indication for 22.2% of all prescribed antimicrobials, and exceeded 24h in 81.5% of cases. The antimicrobials used most often were fluoroquinolones (20.9%), especially for non-surgical prophylaxis (26.8%) and treatment (21.9%). The antimicrobials prescribed most frequently for surgical prophylaxis were first-generation cephalosporins (23.0%), fluoroquinolones (14.7%) and second-generation cephalosporins (11.4%). The use of antimicrobials was higher in patients with invasive medical devices.
  
  
  CONCLUSIONS
  This study found excessive use of broad-spectrum antibiotics, prolonged surgical prophylaxis, frequent use of parenteral antibiotics and inadequate documentation of the indication for prescription. These findings present opportunities for improving the management of antimicrobials in Slovak hospitals.
authors.affiliation: Regional Public Health Authority, Trenčín, Slovak Republic; Faculty of Health Care, Alexander Dubček University, Trenčín, Slovak Republic.
authors.forename: M
authors.initials: M
authors.lastname: Štefkovičová
authors.affiliation: Regional Public Health Authority, Trenčín, Slovak Republic.
authors.forename: S
authors.initials: S
authors.lastname: Litvová
authors.affiliation: Faculty of Health Care, Alexander Dubček University, Trenčín, Slovak Republic.
authors.forename: V
authors.initials: V
authors.lastname: Meluš
authors.affiliation: Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic.
authors.forename: Z
authors.initials: Z
authors.lastname: Krištúfková
authors.affiliation: Regional Public Health Authority, Trenčín, Slovak Republic; Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic. Electronic address: alexandra.brazinova@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Bražinová
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018154:Slovakia; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: Antimicrobial use; Hospitals; Point prevalence survey