Comparing the appropriateness of antimicrobial prescribing among medical patients in two tertiary hospitals in Malaysia

Ly Sia Loong; Pauline Siew Mei Lai; Nurul Adilla Hayat Jamaluddin; Isa Naina-Mohamed; Petrick Periyasamy; Chee Lan Lau; Karin Thursky; Rodney James; Sasheela Ponnampalavanar; The Malaysian NAPS Working Group

doi:10.3855/jidc.15925

Comparing the appropriateness of antimicrobial prescribing among medical patients in two tertiary hospitals in Malaysia

Authors

Ly Sia Loong Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Pauline Siew Mei Lai Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia https://orcid.org/0000-0002-9940-9644
Nurul Adilla Hayat Jamaluddin Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
Isa Naina-Mohamed Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
Petrick Periyasamy Medical Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
Chee Lan Lau Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
Karin Thursky National Centre for Antimicrobial Stewardship (NCAS), University of Melbourne and Royal Melbourne Hospital, Australia
Rodney James National Centre for Antimicrobial Stewardship (NCAS), University of Melbourne and Royal Melbourne Hospital, Australia
Sasheela Ponnampalavanar Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia https://orcid.org/0000-0002-4506-1304
The Malaysian NAPS Working Group

DOI:

https://doi.org/10.3855/jidc.15925

Keywords:

Antimicrobial stewardship, hospital, appropriateness

Abstract

Introduction: Malaysia is an upper-middle-income country with national antimicrobial stewardship programs in place. However, hospitals in this country are faced with a high incidence of multidrug-resistant organisms and high usage of broad-spectrum antibiotics. Therefore, this study aimed to use a standardized audit tool to assess clinical appropriateness, guideline compliance, and prescribing patterns of antimicrobial use among medical patients in two tertiary hospitals in Malaysia to benchmark practice.

Methodology: A prospective hospital-wide point prevalence survey was carried out by a multidisciplinary team in April 2019 at the University Malaya Medical Centre (UMMC) and the Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. Data was collected from the patient’s electronic medical records and recorded using the Hospital National Antimicrobial Prescribing Survey toolkit developed by the National Centre for Antimicrobial Stewardship, Australia.

Results: The appropriateness of prescriptions was 60.1% (UMMC) and 67% (HCTM), with no significant difference between the two hospitals. Compliance with guidelines was 60.0% (UMMC) and 61.5% (HCTM). Amoxicillin-clavulanic acid was the most commonly prescribed antimicrobial (UMMC = 16.9%; HCTM = 11.9%).

Conclusions: The appropriateness of antimicrobial prescribing in medical wards, compliance with guidelines, and prescribing patterns were similar between the two hospitals in Malaysia. The survey identified several areas of prescribing that would need targeted AMS interventions.

Author Biography

The Malaysian NAPS Working Group

Adeeba Kamarulzaman, Sharifah Faridah Syed Omar, Asma Sohail, Pui Li Wong, Bushra Megat Johari, Hang Cheng Ong, Rong Xiang Ng, Anjanna Kukreja, Mia Tuang Koh, Lay Teng Tan, Ching Hooi Tan, Chuey Ee Lee, Ka Yin Lim, Mei Kuan Yin, Nur Jannah Azman, Najma Kori, Ramliza Ramli, Toh Leong Tan.

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Published

2022-12-31

How to Cite

Loong LS, Siew Mei Lai P, Jamaluddin NAH, Naina-Mohamed I, Periyasamy P, Lau CL, Thursky K, James R, Ponnampalavanar S, The Malaysian NAPS Working Group (2022) Comparing the appropriateness of antimicrobial prescribing among medical patients in two tertiary hospitals in Malaysia. J Infect Dev Ctries 16:1877–1886. doi: 10.3855/jidc.15925

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Issue

Vol. 16 No. 12: December 2022

Section

Original Articles

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