The enhancing role of pharmacovigilance to conventional antibiotic resistance surveillance: cross-sectional identification and analysis of reports of antibiotic resistance in VigiBase

Abstract

Objectives

This study aimed to identify and analyze potential cases of antibiotic resistance in a global pharmacovigilance database.

Methods

A search of VigiBase, the World Health Organization global database of adverse event reports, was done on data up to October 3, 2022 to identify suspected cases of antibiotic resistance. Reports were classified as being “probable” or “possible” to represent cases of antibiotic resistance.

Results

In total, 24,312 reports of potential antibiotic resistance cases were identified during the search, with 3497 classified as probable reports and 20,815 as possible reports based on their preferred terms. For the probable reports, 91.5% were found to be “very likely” or “likely” related to antibiotic resistance, although the reporting of antimicrobial susceptibility testing (38.3% of reviewed “probable” reports and 7.2% of reviewed “possible” reports) and previous antibiotic use (12.8% of reviewed “probable” reports and 9.0% of reviewed “possible” reports) was limited. The “possible” reports identified cases of antibiotic resistance with less accuracy but highlighted important information around unexpected antibiotic failure.

Conclusions

This study provides an in-depth overview of antibiotic resistance reporting in VigiBase. Certain terms identified cases with good accuracy and can contain supplementary information to conventional antibiotic resistance surveillance. These findings can guide future research; however, researchers must be aware of inherent limitations and biases.