{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:02:01Z","timestamp":1790136121683,"version":"4.0.1"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Inc","award":["73564825"],"award-info":[{"award-number":["73564825"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Tackling the inertia of growing threat of antimicrobial resistance (AMR) requires changes in how antibiotics are prescribed and utilized. The monitoring of antimicrobial prescribing in hospitals is a critical component in optimizing antibiotic use. Point prevalence surveys (PPSs) enable the surveillance of antibiotic prescribing at the patient level in small hospitals that lack the resources to establish antimicrobial stewardship programs (ASP). In this study, we analyzed antibiotic use at two public secondary care hospitals in Mexico using PPSs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Following WHO methodology, we conducted four cross-sectional PPSs on antibiotic use in two public secondary care facilities in Mexico: two surveys in a women\u2019s specialty hospital (H1) and two in a general referral hospital (H2). We collected data from clinical records of all patients with active antibiotic prescriptions (APs) across the medical, surgical, and mixed (MIX) wards, and intensive care units (ICUs). Descriptive statistics were computed to analyze the PPSs data using Stata.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The PPSs collected data on 127 patients, and 283 active APs. The prevalence of antibiotic use was 60.4% (H1, <jats:italic>n<\/jats:italic> = 29\/48) and 70.5% (H2, <jats:italic>n<\/jats:italic> = 98\/139). Antibiotics were more frequently used among patients in the MIX wards (H1: 87.5%, <jats:italic>n<\/jats:italic> = 14\/16) and ICUs (H2: 90%, <jats:italic>n<\/jats:italic> = 9\/10). The most frequent patient indications for antibiotic use were medical prophylaxis (H1: 51.7%, <jats:italic>n<\/jats:italic> = 15\/29), community-acquired infections (H2: 42.9%, <jats:italic>n<\/jats:italic> = 42\/98), and preoperative prophylaxis (H1: 27.6%, <jats:italic>n<\/jats:italic> = 8\/29; H2: 23.5%, <jats:italic>n<\/jats:italic> = 23\/98). The APs were mostly empirical (H1: 97%, <jats:italic>n<\/jats:italic> = 64\/66; H2: 98.2%, <jats:italic>n<\/jats:italic> = 213\/217), and parenterally administered (H1: 90.9%, <jats:italic>n<\/jats:italic> = 60\/66; H2: 96.8%, <jats:italic>n<\/jats:italic> = 210\/217). Most clinical records lacked documented post-prescription reviews (H1: 82.8%, <jats:italic>n<\/jats:italic> = 24\/29; H2: 98%, <jats:italic>n<\/jats:italic> = 96\/98). Preoperative prophylaxis was predominantly administered as multiple doses for more than one day. Penicillins with extended-spectrum (24.2%, <jats:italic>n<\/jats:italic> = 16\/66), aminoglycosides (22.7%, <jats:italic>n<\/jats:italic> = 15\/66), and first-generation cephalosporins (16.7%, <jats:italic>n<\/jats:italic> = 11\/66) were the most prescribed antibiotic classes in H1, while third-generation cephalosporins (35%, <jats:italic>n<\/jats:italic> = 76\/217), fluoroquinolones (14.3%, <jats:italic>n<\/jats:italic> = 31\/217), and carbapenems (13.4%, <jats:italic>n<\/jats:italic> = 29\/217) were the most prescribed in H2. No hospital had formally established ASP.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study shows high prevalence rates of antibiotic use and variations in commonly prescribed antibiotic classes in public Mexican secondary care hospitals, along with shared practices in broad-spectrum antibiotic prescription. PPS-based surveillance enables the identification of specific targets to optimize antibiotic use according to the healthcare needs of patients in each hospital and facilitates comparative evaluations across hospitals.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315925","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T18:45:27Z","timestamp":1735929927000},"page":"e0315925","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Point prevalence survey of antibiotic use in Mexican secondary care hospitals"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8764-4375","authenticated-orcid":true,"given":"Federico A.","family":"Zumaya-Estrada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia M.","family":"Alpuche-Aranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilda Ivonne","family":"Huerta Icelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe D.","family":"Neri-Estrada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica M.","family":"Calixto Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haydee E.","family":"Quiroz Escoriza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-3050","authenticated-orcid":true,"given":"Jesus Ulises","family":"Garza-Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro J.","family":"Saturno-Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"pone.0315925.ref001","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3201\/eid2305.161556","article-title":"The discovery of penicillin\u2014new insights after more than 75 years of clinical use","volume":"23","author":"R. Gaynes","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"pone.0315925.ref002","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S0140-6736(15)00473-0","article-title":"Understanding the mechanisms and drivers of antimicrobial resistance","volume":"387","author":"AH Holmes","year":"2016","journal-title":"The Lancet"},{"key":"pone.0315925.ref003","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"399","author":"CJ Murray","year":"2022","journal-title":"The Lancet"},{"key":"pone.0315925.ref004","article-title":"Review on Antimicrobial Resistance, Tackling drug-resistant infections globally: final report and recommendations","author":"J. O\u2019Neill","year":"2016","journal-title":"Government of the United Kingdom"},{"key":"pone.0315925.ref005","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.2007","article-title":"Assessment of the Appropriateness of Antimicrobial Use in US Hospitals","volume":"4","author":"SS Magill","year":"2021","journal-title":"JAMA Netw Open"},{"key":"pone.0315925.ref006","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1001\/jamainternmed.2017.1938","article-title":"Association of adverse events with antibiotic use in hospitalized patients","volume":"177","author":"PD Tamma","year":"2017","journal-title":"JAMA Intern Med"},{"key":"pone.0315925.ref007","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1086\/666642","article-title":"Recent Exposure to Antimicrobials and Carbapenem-Resistant Enterobacteriaceae: The Role of Antimicrobial Stewardship","volume":"33","author":"D Marchaim","year":"2012","journal-title":"Infect Control Hosp Epidemiol"},{"key":"pone.0315925.ref008","doi-asserted-by":"crossref","first-page":"e1001104","DOI":"10.1371\/journal.pmed.1001104","article-title":"Mortality and hospital stay associated with resistant Staphylococcus aureus and Escherichia coli bacteremia: Estimating the burden of antibiotic resistance in Europe","volume":"8","author":"MEA de Kraker","year":"2011","journal-title":"PLoS Med"},{"issue":"2","key":"pone.0315925.ref009","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD003543.pub4","article-title":"Interventions to improve antibiotic prescribing practices for hospital inpatients","author":"P Davey","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0315925.ref010","unstructured":"General Health Council. Agreement declaring the mandatory nature of the National Strategy for action against Antimicrobial Resistance. In: https:\/\/dof.gob.mx\/nota_detalle.php?codigo=5525043&fecha=05\/06\/2018#gsc.tab=0. 5 Jun 2018."},{"key":"pone.0315925.ref011","doi-asserted-by":"crossref","first-page":"442","DOI":"10.3855\/jidc.13467","article-title":"Antibiotic usage and resistance in Mexico: an update after a decade of change","volume":"15","author":"CF Amabile-Cuevas","year":"2021","journal-title":"J Infect Dev Ctries"},{"key":"pone.0315925.ref012","volume-title":"Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries: a practical toolkit","author":"World Health Organization","year":"2019"},{"key":"pone.0315925.ref013","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.cmi.2017.07.010","article-title":"Antibiotic stewardship in low- and middle-income countries: the same but different?","volume":"23","author":"JA Cox","year":"2017","journal-title":"Clinical Microbiology and Infection"},{"key":"pone.0315925.ref014","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.ijid.2020.05.126","article-title":"Global Antimicrobial Stewardship with a Focus on Low- and Middle-Income Countries","volume":"96","author":"J Pierce","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0315925.ref015","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1086\/644617","article-title":"The european surveillance of antimicrobial consumption (ESAC) point-prevalence survey of antibacterial use in 20 European hospitals in 2006","volume":"49","author":"F Ansari","year":"2009","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0315925.ref016","first-page":"1","volume-title":"WHO Methodology for Point Prevalence Survey on Antibiotic Use in Hospitals version 1.1","author":"World Health Organization"},{"key":"pone.0315925.ref017","doi-asserted-by":"crossref","first-page":"e619","DOI":"10.1016\/S2214-109X(18)30186-4","article-title":"Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey","volume":"6","author":"A Versporten","year":"2018","journal-title":"Lancet Glob Health"},{"key":"pone.0315925.ref018","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.23.46.1800393","article-title":"Antimicrobial use in european acute care hospitals: Results from the second point prevalence survey (PPS) of healthcare-associated infections and antimicrobial use, 2016 to 2017","volume":"23","author":"D Plachouras","year":"2018","journal-title":"Eurosurveillance"},{"key":"pone.0315925.ref019","doi-asserted-by":"crossref","first-page":"S683","DOI":"10.1093\/ofid\/ofz360.1714","article-title":"Standardized Point Prevalence Survey on Antibiotic Use to Inform Antimicrobial Stewardship Strategies in the Caribbean","volume":"6","author":"J Hsieh","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"pone.0315925.ref020","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/jac\/dkab459","article-title":"Point prevalence survey of antibiotic use in hospitals in Latin American countries","volume":"77","author":"G Levy Hara","year":"2022","journal-title":"Journal of Antimicrobial Chemotherapy"},{"key":"pone.0315925.ref021","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ijid.2019.06.016","article-title":"One-day point prevalence of healthcare-associated infections and antimicrobial use in four countries in Latin America","volume":"86","author":"R Huerta-Guti\u00e9rrez","year":"2019","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0315925.ref022","doi-asserted-by":"crossref","first-page":"4553","DOI":"10.2147\/IDR.S327721","article-title":"Point prevalence survey of antimicrobial use in four tertiary care hospitals in Mexico","volume":"14","author":"FA Zumaya-Estrada","year":"2021","journal-title":"Infect Drug Resist"},{"key":"pone.0315925.ref023","unstructured":"General Directorate of Health Information (DGIS), Ministry of Health of Mexico. Unique Health Establishment Code Catalog (CLUES). In: http:\/\/gobi.salud.gob.mx\/gobi\/catalogos\/catalogosmaestros\/ESTABLECIMIENTO_SALUD_202409.xlsx?V=2024.10.30. Sep 2024."},{"key":"pone.0315925.ref024","doi-asserted-by":"crossref","first-page":"e005671","DOI":"10.1136\/bmjgh-2021-005671","article-title":"Trends and projections of caesarean section rates: Global and regional estimates","volume":"6","author":"AP Betran","year":"2021","journal-title":"BMJ Glob Health"},{"key":"pone.0315925.ref025","doi-asserted-by":"crossref","first-page":"e390","DOI":"10.1016\/S2214-109X(17)30020-7","article-title":"The Global Maternal and Neonatal Sepsis Initiative: a call for collaboration and action by 2030","volume":"5","author":"TG Maternal","year":"2017","journal-title":"Lancet Glob Health"},{"key":"pone.0315925.ref026","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1093\/cid\/ciw588","article-title":"Antibiotic Use in Small Community Hospitals","volume":"63","author":"E Stenehjem","year":"2016","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0315925.ref027","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology. WHO Anatomical Therapeutic Chemical (ATC) Classification. In: https:\/\/atcddd.fhi.no\/atc_ddd_index\/. 10 May 2024."},{"key":"pone.0315925.ref028","unstructured":"Morelos Health Services. Women\u2019s Hospital. Technical Data Sheets 2023. In: https:\/\/www.ssm.gob.mx\/portal\/diagnostico-estatal-en-salud\/2023\/2023-1\/Hospital%20de%20la%20Mujer.pdf. 2023."},{"key":"pone.0315925.ref029","unstructured":"Morelos Health Services. Cuernavaca General Hospital. Technical Data Sheets 2023. In: https:\/\/www.ssm.gob.mx\/portal\/diagnostico-estatal-en-salud\/2023\/2023-1\/Hospital-General-de-Cuernavaca.pdf. 2023."},{"key":"pone.0315925.ref030","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pone.0315925.ref031","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1017\/ice.2016.115","article-title":"A Concise Set of Structure and Process Indicators to Assess and Compare Antimicrobial Stewardship Programs Among EU and US Hospitals: Results From a Multinational Expert Panel","volume":"37","author":"LA Pollack","year":"2016","journal-title":"Infect Control Hosp Epidemiol"},{"key":"pone.0315925.ref032","first-page":"13","volume-title":"International Journal of Infectious Diseases","author":"FA Zumaya-Estrada","year":"2021"},{"key":"pone.0315925.ref033","volume-title":"Stata: Release 17. Statistical Software","author":"StataCorp","year":"2021"},{"key":"pone.0315925.ref034","unstructured":"World Health Organization. 2019 WHO AWaRe Classification Database of Antibiotics for evaluation and monitoring of use. 2019 [cited 4 Sep 2024]. https:\/\/www.who.int\/publications\/i\/item\/WHOEMPIAU2019.11."},{"key":"pone.0315925.ref035","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1001\/jama.2014.12923","article-title":"Prevalence of antimicrobial use in us acute care hospitals, may-september 2011","volume":"312","author":"SS Magill","year":"2014","journal-title":"JAMA\u2014Journal of the American Medical Association"},{"key":"pone.0315925.ref036","doi-asserted-by":"crossref","first-page":"504","DOI":"10.21149\/8465","article-title":"Prevalencia de uso de antimicrobianos entre pacientes hospitalizados en \u00e1reas no cr\u00edticas en un hospital universitario de M\u00e9xico","volume":"59","author":"M Soria-Orozco","year":"2017","journal-title":"Salud Publica Mex"},{"key":"pone.0315925.ref037","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1055\/s-0042-1757585","article-title":"Point Prevalence Study (PPS) of Antibiotic Usage and Bacterial Culture Rate (BCR) among Secondary Care Hospitals of Small Cities in Central India: Consolidating Indian Evidence","volume":"15","author":"S Kumar","year":"2023","journal-title":"J Lab Physicians"},{"key":"pone.0315925.ref038","doi-asserted-by":"crossref","first-page":"41","DOI":"10.7897\/2230-8407.099185","article-title":"The Third-Generation Cephalosporin Use in a Regional General Hospital in Indonesia","volume":"9","author":"R Yulia","year":"2018","journal-title":"International Research Journal Of Pharmacy"},{"key":"pone.0315925.ref039","unstructured":"World Health Organization. The WHO AWaRe (Access, Watch, Reserve) antibiotic book. 2022 [cited 4 Sep 2024]. https:\/\/www.who.int\/publications\/i\/item\/WHOEMPIAU2019.11."},{"key":"pone.0315925.ref040","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1093\/jac\/dkab050","article-title":"Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): Results from a worldwide point prevalence survey in 69 countries","volume":"76","author":"I Pauwels","year":"2021","journal-title":"Journal of Antimicrobial Chemotherapy"},{"key":"pone.0315925.ref041","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S1473-3099(17)30724-7","article-title":"Classifying antibiotics in the WHO Essential Medicines List for optimal use\u2014be AWaRe","author":"M Sharland","year":"2018","journal-title":"The Lancet Infectious Diseases"},{"key":"pone.0315925.ref042","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/j.cmi.2022.03.014","article-title":"Exposure to World Health Organization\u2019s AWaRe antibiotics and isolation of multidrug resistant bacteria: a systematic review and meta-analysis","author":"G Sulis","year":"2022","journal-title":"Clinical Microbiology and Infection"},{"key":"pone.0315925.ref043","volume-title":"StatPearls","author":"MF Crader","year":"2024"},{"key":"pone.0315925.ref044","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/S1473-3099(12)70239-6","article-title":"Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: A prospective cohort study","volume":"12","author":"MM Levy","year":"2012","journal-title":"Lancet Infect Dis"},{"key":"pone.0315925.ref045","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/1129729820978124","article-title":"Incidence, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalised adult patients","volume":"23","author":"C Liu","year":"2022","journal-title":"Journal of Vascular Access"},{"key":"pone.0315925.ref046","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.4065\/81.9.1159","article-title":"The risk of bloodstream infection in adults with different intravascular devices: A systematic review of 200 published prospective studies","volume":"81","author":"DG Maki","year":"2006","journal-title":"Mayo Clin Proc"},{"key":"pone.0315925.ref047","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.amjmed.2006.03.034","article-title":"Benefit of Appropriate Empirical Antibiotic Treatment: Thirty-day Mortality and Duration of Hospital Stay","volume":"119","author":"A Fraser","year":"2006","journal-title":"American Journal of Medicine"},{"key":"pone.0315925.ref048","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/S0140-6736(15)60733-4","article-title":"Community-acquired pneumonia","volume":"386","author":"E Prina","year":"2015","journal-title":"Lancet"},{"key":"pone.0315925.ref049","doi-asserted-by":"crossref","first-page":"S110","DOI":"10.1093\/infdis\/jiaa146","article-title":"A critical analysis of the literature on time-to-antibiotics in suspected sepsis","volume":"222","author":"J Weinberger","year":"2020","journal-title":"Journal of Infectious Diseases"},{"key":"pone.0315925.ref050","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1097\/CCM.0000000000000330","article-title":"Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: Results from a guideline-based performance improvement program","volume":"42","author":"R Ferrer","year":"2014","journal-title":"Crit Care Med"},{"key":"pone.0315925.ref051","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13054-015-0795-y","article-title":"Incidence and outcome of inappropriate in-hospital empiric antibiotics for severe infection: A systematic review and meta-analysis","volume":"19","author":"K Marquet","year":"2015","journal-title":"Crit Care"},{"key":"pone.0315925.ref052","doi-asserted-by":"crossref","first-page":"i51","DOI":"10.1093\/jac\/dks202","article-title":"Improving the quality of antibiotic prescribing in the nhs by developing a new antimicrobial stewardship programme: Start smart-then focus","volume":"67","author":"D Ashiru-oredope","year":"2012","journal-title":"Journal of Antimicrobial Chemotherapy"},{"key":"pone.0315925.ref053","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1016\/S1473-3099(16)30024-X","article-title":"Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines","author":"BJ McMullan","year":"2016","journal-title":"The Lancet Infectious Diseases"},{"key":"pone.0315925.ref054","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1001\/jamainternmed.2016.3646","article-title":"The new antibiotic mantra-\"shorter is better\"","author":"B. Spellberg","year":"2016","journal-title":"JAMA Internal Medicine"},{"key":"pone.0315925.ref055","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1001\/jamainternmed.2016.3633","article-title":"Duration of antibiotic treatment in community-acquired pneumonia: A multicenter randomized clinical trial","volume":"176","author":"A Uranga","year":"2016","journal-title":"JAMA Intern Med"},{"key":"pone.0315925.ref056","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1093\/cid\/ciy1054","article-title":"Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial","volume":"69","author":"D Yahav","year":"2019","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0315925.ref057","doi-asserted-by":"crossref","first-page":"336","DOI":"10.12788\/jhm.2905","article-title":"Shorter versus longer courses of antibiotics for infection in hospitalized patients: A systematic review and meta-analysis","author":"S Royer","year":"2018","journal-title":"Journal of Hospital Medicine"},{"key":"pone.0315925.ref058","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1001\/archinternmed.2012.1690","article-title":"Effect of a 3-step critical pathway to reduce duration of intravenous antibiotic therapy and length of stay in community-acquired pneumonia: A randomized controlled trial","volume":"172","author":"J Carratal\u00e0","year":"2012","journal-title":"Arch Intern Med"},{"key":"pone.0315925.ref059","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1136\/bmj.38993.560984.BE","article-title":"Effectiveness of early switch from intravenous to oral antibiotics in severe community acquired pneumonia: Multicentre randomised trial","volume":"333","author":"JJ Oosterheert","year":"2006","journal-title":"Br Med J"},{"key":"pone.0315925.ref060","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1093\/cid\/ciad196","article-title":"Intravenous to Oral Antibiotic Switch Therapy among Patients Hospitalized with Community-Acquired Pneumonia","volume":"77","author":"A Deshpande","year":"2023","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0315925.ref061","first-page":"CD009516","article-title":"Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery","author":"AD Mackeen","year":"2014","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0315925.ref062","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3389\/fnut.2019.00004","article-title":"Breast milk microbiota is shaped by mode of delivery and intrapartum antibiotic exposure","volume":"6","author":"H Hermansson","year":"2019","journal-title":"Front Nutr"},{"key":"pone.0315925.ref063","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s40168-017-0313-3","article-title":"Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates","volume":"5","author":"A Nogacka","year":"2017","journal-title":"Microbiome"},{"key":"pone.0315925.ref064","unstructured":"National Institute for Health and Care Excellence (NICE). Surgical site infections: prevention and treatment. In: www.nice.org.uk\/guidance\/ng125. 19 Aug 2020."},{"key":"pone.0315925.ref065","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1093\/cid\/ciw323","article-title":"Antibiotic stewardship programs in U.S. acute care hospitals: Findings from the 2014 national healthcare safety network annual hospital survey","author":"LA Pollack","year":"2016","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0315925.ref066","doi-asserted-by":"crossref","first-page":"266","DOI":"10.2471\/BLT.17.203448","article-title":"Antibiotic stewardship interventions in hospitals in low-and middle-income countries: A systematic review","author":"C van Dijck","year":"2018","journal-title":"Bulletin of the World Health Organization"},{"key":"pone.0315925.ref067","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1093\/cid\/ciad184","article-title":"Deep Dive Into Gaps and Barriers to Implementation of Antimicrobial Stewardship Programs in Hospitals in Latin America","volume":"77","author":"V Fabre","year":"2023","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0315925.ref068","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S1473-3099(20)30332-7","article-title":"Assessment of WHO antibiotic consumption and access targets in 76 countries, 2000\u201315: an analysis of pharmaceutical sales data","volume":"21","author":"EY Klein","year":"2021","journal-title":"Lancet Infect Dis"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T18:45:47Z","timestamp":1735929947000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315925"}},"subtitle":[],"editor":[{"given":"Mabel Kamweli","family":"Aworh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":68,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0315925","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}