article · JAC-Antimicrobial Resistance
Although more than 80% of antimicrobials are prescribed in outpatient settings, surveillance tools have historically focused on inpatient care. To address this gap, the Global Point Prevalence Survey developed a standardised outpatient module to capture prescribing patterns. The methodology gathers core variables for all ambulatory patients alongside detailed data for those receiving antimicrobial prescriptions. Between May 2023 and December 2024, an assessment was conducted using a 34-question survey completed by healthcare workers who piloted the module, primarily based in Nigeria, Ghana, and Guinea. User satisfaction was above 90%, and the web-based system provided real-time reporting alongside data entry and validation. However, three quarters of participating facilities reported implementation barriers. Common obstacles included difficulties accessing patient records, obtaining clinical details during consultations, and an absence of trained personnel, pointing to a need for targeted training and support.
Most antibiotics are prescribed outside hospitals, yet monitoring systems usually track only inpatient wards. Unchecked outpatient prescribing accelerates antimicrobial resistance. Having an accessible, standardized digital tool allows outpatient clinics to systematically document prescribing habits, uncover weaknesses, and guide stewardship programmes to safeguard critical medicines.
The tool is applied and tested, functioning as a free web-based platform with real-time reporting and data entry. Healthcare facilities, clinical networks, and public health organisations can implement it immediately for outpatient surveillance. Uptake could enable digital health providers or training bodies to deliver supplementary workforce education and workflow solutions to help clinics overcome medical record access issues and operational constraints identified during deployment.
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Abstract Objectives Many tools for antimicrobial use surveillance have been exclusively developed for inpatient settings, although >80% of all antimicrobials are prescribed in outpatient care. In this study, we describe the methodology and first evaluation of the outpatient Global Point Prevalence Survey (Global-PPS). Methods Global-PPS developed a standardized tool to measure outpatient antimicrobial prescribing patterns. A core set of variables was collected for all ambulatory patients, and more detailed data for those prescribed antimicrobials during the survey. A questionnaire containing 34 questions on experiences with the outpatient Global-PPS was administered to users who had used the outpatient module of the Global-PPS between May 2023 and December 2024. Results In total, 39 (29.1%) participants of the outpatient Global-PPS from 25 (71.4%) different healthcare facilities responded to the questionnaire, of which 25 (from 16 facilities) completed it. Most respondents were from Nigeria (50%), Ghana (12.5%) or Guinea (10%). Respondent satisfaction was very high (>90%, n = 25), although additional training and support tools seemed to be needed. Most facilities (75%, n = 16) encountered certain barriers to conducting the survey, including challenges in obtaining patient information during consultation (44%) or accessing medical records (28%), and a lack of trained staff (16%). Conclusions The outpatient Global-PPS is the first freely available web-based standardized tool for measuring antimicrobial use in outpatient care worldwide, featuring an online data entry platform, validation and real-time reporting. This study confirmed a high degree of satisfaction among participants, although additional support is needed to train staff and overcome certain barriers, including access to patient information.
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DOI: 10.1093/jacamr/dlaf115
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