Global Point Prevalence Survey (PPS)

The Global Point Prevalence Survey (PPS) is an international initiative designed to monitor and evaluate patterns of antimicrobial prescribing and resistance across healthcare facilities worldwide. By collecting data at a specific point in time, the PPS provides valuable insights into the use of antibiotics and antifungal agents, enabling hospitals and policymakers to identify trends, benchmark practices, and develop strategies to improve antimicrobial stewardship.

Background

The misuse and overuse of antimicrobial agents have become critical global health challenges, contributing to the emergence and spread of antimicrobial resistance (AMR). Recognising the need for systematic monitoring, the PPS was launched to provide standardised and comparable data on antimicrobial consumption across diverse healthcare settings.
Initially piloted in Europe, the survey has since expanded to include hospitals from over 70 countries, making it one of the most comprehensive efforts to track antimicrobial use globally.

Objectives

The Global PPS seeks to:

• Quantify the proportion of hospitalised patients receiving antimicrobials at the time of survey.
• Identify the most commonly prescribed antibiotics and antifungals.
• Examine the indications for prescribing, such as treatment of infections or surgical prophylaxis.
• Assess the appropriateness of prescriptions against established guidelines.
• Support hospitals in developing local antimicrobial stewardship programmes.
• Facilitate international comparisons and benchmarking to improve prescribing practices.

Methodology

The PPS follows a standardised protocol to ensure data comparability:

• Data collection period: A survey is conducted on a single day (or within a short time frame) across participating hospitals.
• Scope: Includes all inpatients at the time of data collection.
• Data recorded: Information such as patient demographics, prescribed antimicrobial agents, route of administration, dosage, diagnosis, and justification for use.
• Analysis: Data are aggregated at hospital, national, and global levels, providing both local insights and broader international trends.

Key Findings from Global PPS

Results from successive PPS cycles have revealed important patterns:

• A significant proportion of hospital inpatients worldwide receive at least one antimicrobial agent.
• Broad-spectrum antibiotics are widely used, often as empirical treatment.
• Inappropriate prescribing, including unnecessary surgical prophylaxis or deviation from guidelines, remains common.
• Regional variations exist, with higher rates of antimicrobial use in certain low- and middle-income countries compared to high-income nations.
• Data highlight the need for better diagnostic support, adherence to stewardship principles, and reduction of prolonged antibiotic use.

Applications

The findings from the Global PPS serve multiple purposes:

• Policy development: Informing national and institutional policies on antimicrobial stewardship.
• Hospital benchmarking: Allowing hospitals to compare their prescribing rates with peers globally.
• Capacity building: Supporting training and awareness among healthcare professionals.
• Global surveillance: Complementing other monitoring systems, such as the World Health Organization’s GLASS (Global Antimicrobial Resistance and Use Surveillance System).

Challenges

While the PPS has been successful in generating global data, several challenges remain:

• Resource constraints: Hospitals in low-income settings may lack staff and infrastructure for detailed data collection.
• Data limitations: Being a cross-sectional survey, PPS does not capture long-term prescribing trends or outcomes.
• Variation in adherence: Inconsistent compliance with survey methodology can affect data reliability.
• Implementation gap: Translating findings into sustained stewardship practices can be difficult in under-resourced health systems.

Significance

The Global Point Prevalence Survey plays a vital role in tackling antimicrobial resistance by providing a clear picture of how antibiotics are used in hospitals worldwide. Its standardised approach allows comparison across regions and fosters global collaboration in combating AMR.