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Surveillance of antibiotics use in inpatients at Benjamin Mkapa Zonal Referral Hospital in Dodoma, Tanzania: a point prevalence survey.
Zimbwe, Kauke Bakari; Yona, Yusto Julius; Chiwambo, Charity Alphonce; Chandika, Alphonce Bilola; Kiwelu, Humphrey Sawira; Kizenga, Omary Salim; Mleke, Mfaume Michael; Shabani, Moshi Moshi.
Afiliación
  • Zimbwe KB; Pharmacy and Compounding Section, Oncology, Haematology and BMT Pharmacy, The Benjamin Mkapa Hospital, Dodoma, United Republic of Tanzania zimbwekauke@gmail.com.
  • Yona YJ; Pharmacy and Compounding Section, Oncology, Haematology and BMT Pharmacy, The Benjamin Mkapa Hospital, Dodoma, United Republic of Tanzania.
  • Chiwambo CA; Pharmacy Department, The Aga Khan Hospital Trust, Dar es salaam, United Republic of Tanzania.
  • Chandika AB; Hospital Executive Committee, The Benjamin Mkapa Hospital, Dodoma, United Republic of Tanzania.
  • Kiwelu HS; Clinical Support Directorate, The Benjamin Mkapa Hospital, Dodoma, United Republic of Tanzania.
  • Kizenga OS; Medicines Registration Department, Tanzania Medicines and Medical Devices Authority, Dodoma, United Republic of Tanzania.
  • Mleke MM; Pharmacy and Compounding Section, Oncology, Haematology and BMT Pharmacy, The Benjamin Mkapa Hospital, Dodoma, United Republic of Tanzania.
  • Shabani MM; Biomedical Research and Clinical Trials Department, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
BMJ Open ; 14(8): e083444, 2024 Aug 03.
Article en En | MEDLINE | ID: mdl-39097319
ABSTRACT

OBJECTIVE:

To assess antibiotics prescribing and use patterns for inpatients at Benjamin Mkapa Zonal Referral Hospital (BMH) using the WHO-Point Prevalence Survey (WHO-PPS).

DESIGN:

A cross-sectional survey.

SETTING:

The Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania.

PARTICIPANTS:

Inpatient prescriptions, regardless of whether antibiotics were prescribed (n=286) on the day of PPS. OUTCOME

MEASURES:

Our study analysed the prevalence of antibiotic use at BMH for inpatients, the type of antibiotics used, the indications for use and the proportion of oral and parenteral antibiotics. We also assessed prescription-prescribed antibiotics after a positive antimicrobial susceptibility testing (AST) result.

RESULTS:

A survey was conducted on 286 prescriptions, which revealed that 30.07% of them included antibiotics. On average, each prescription contained at least 1.6 antibiotics. All prescriptions that included antibiotics were written in generic names, and 77.91% (67/86) of them followed the Standard Treatment Guidelines. Of the prescriptions that included antibiotics, 58.14% (50/86) had a single antibiotic, 20.93% (18/86) had parenteral antibiotics and 79.07% (68/86) had oral antibiotics. Based on AWaRe's (Access, Watch and Reserve) categorisation of antibiotics, 50% (8/16) were in the Access group, 31.25% (5/16) were in the Watch group, 12.50% (2/16) were in the Reserve group and 6.25% (1/16) were not recommended antimicrobial combinations. Out of 86 prescriptions included antibiotics, only 4.65% showed positive culture growth. However, antibiotics were still prescribed in 29.07% of prescriptions where there was no growth of bacteria, and in 66.28% of prescriptions, antibiotics were prescribed empirically without any requesting of bacteria culture and AST.

CONCLUSION:

BMH has reduced inpatient Antibiotic Use by half compared with the 2019 WHO-PPS. Adherence to National Treatment Guidelines is suboptimal. Clinicians should use AST results to guide antibiotic prescribing.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Antibacterianos Límite: Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Antibacterianos Límite: Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido