Antimicrobial utilization among hospitalized patients according to WHO AWaRe classification: Results from a multicentre point prevalence survey in Saudi Arabia
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Antimicrobial resistance (AMR) threatens global health by reducing the efficacy of common infection treatments. This study examines antimicrobial use in Saudi Arabian hospitals, identifies influencing factors, and proposes interventions using the World Health Organization's (WHO) Access, Watch, Reserve (AWaRe) classification system. METHODS: A cross-sectional, multicentre point prevalence survey (PPS) of antimicrobial utilization was conducted in 10 hospitals across 6 regions of Saudi Arabia September 2023. All inpatients receiving antimicrobials on the PPS day were included. Data collection utilized the Global PPS tool developed by the University of Antwerp, Belgium. RESULTS: Among 2890 inpatients, 766 (26.5%) were prescribed at least one antimicrobial, resulting in a total of 982 prescriptions. The primary indications for these antimicrobials were community-acquired infections (37.1%), Healthcare-associated infections (35.9%), surgical prophylaxis (15.4%), unknown reasons (8.7%), medical prophylaxis (2.5%), and other reasons (0.3%). The most common reasons for antimicrobial use included pneumonia or lower respiratory tract infections (16.1%), skin and soft tissue infections (11%) and bacteraemia (8.9%). The most frequently prescribed antimicrobial classes were penicillins with beta-lactamase inhibitors (18.5%), carbapenems (15.7%), and third-generation cephalosporins (11.1%). Most of the antimicrobials (66.3%) were classified as Watch antimicrobials, followed by 23.8% as Access, and 8.9% as Reserve. CONCLUSIONS: The study provides valuable insights into antimicrobial utilization in Saudi Arabia, offering a baseline for assessing prescribing patterns. While findings may reflect certain antimicrobial stewardship efforts, further investigation is needed to evaluate their impact. The study also highlights key areas for improvement, emphasizing the importance of conducting future PPS to guide antimicrobial stewardship strategies and monitor progress in managing AMR.
Authors: Nada A. Alsaleh, Abeer AlSmari, Abrar F. Alhameed, Ahmed O. Alenazi, Alaa A. Alsharif, Amal Bin Akresh, Anwar M. Alnakhli, Bashaier Alshehail, Eman A. Alzahrani, Ghadah H. Alshehri, Ghazwa B. Korayem, Hanan A. Bakri, Khalid Eljaaly, Lina I. Alnajjar, Norah S. Aldeghaither, Reem Almahasna, Sara Almuhisen, Yassmin Alsomali, Zikria Saleem
Institutions: Princess Nourah bint Abdulrahman University, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, King Faisal Specialist Hospital & Research Centre, Riyadh Armed Forces Hospital, Imam Abdulrahman Bin Faisal University, King Fahad Central Hospital, King Abdulaziz University, King Fahad Specialist Hospital, King Fahd Medical City, Bahauddin Zakariya University, Qassim University
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $1,890
Awards: G117312533, G4459357278
OpenAlex ID: W4414477700