Antimicrobial prescribing patterns at a South African tertiary referral hospital: insights from three Global Point Prevalence Surveys

Antimicrobial resistance (AMR) is a pressing global health challenge, with sub-Saharan Africa experiencing the highest burden of AMR-related deaths.Inappropriate prescribing and rising antibiotic consumption drive AMR, while limited local data hampers antimicrobial stewardship efforts.This study analysed Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) data from Tygerberg Hospital to identify antimicrobial use trends and inform stewardship priorities.Standard Global-PPS methodology was employed at three distinct time points.All inpatients prescribed at least one antimicrobial on the day of each survey were included in the analysis.Among 3,524 hospitalized patients, 25.9% (911/3,524) received antimicrobial therapy.Overall antimicrobial use decreased significantly (p < 0.05), with the largest reduction among paediatric patients (p < 0.01).Community-acquired infections accounted for the majority of prescriptions (50.7%; 483/952) and empirical antibiotic use was high (85.3%,872/1022).'Access' antibiotics constituted 62.7% (750/1196) of prescriptions.Single-dose prescriptions for surgical prophylaxis accounted for 17.6% (15/85).This study demonstrates progress in stewardship, particularly among paediatric inpatients.Ongoing monitoring of broad-spectrum antibiotic use and adherence to single-dose surgical prophylaxis guidelines are essential priorities.Continued Global-PPS surveillance is crucial to track trends and guide future AMS interventions.