Aaron O Aboderin1, Adeyemi T Adeyemo2, Ademola A Olayinka3, Adeniyi S Oginni4, Abolaji T Adeyemo5, Abayomi A Oni6, Olatunde F Olabisi7, Oluwaseun D Fayomi8, Anthony C Anuforo9, Abiodun Egwuenu10, Omotayo Hamzat11, Walter Fuller12. 1. MBChB, MSc, FMCPath, FRCPath, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria. 2. MBBS, FMCPath, Department of Medical Microbiology, Obafemi Awolowo University, Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria. 3. MSc, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University, PMB 13, Ile-Ife, Nigeria. 4. MBChB, PhD, Osun State Health Insurance Scheme, Ogo-Oluwa, Osogbo, Nigeria. 5. MBBS, FWACP, Department of Medical Microbiology, Ladoke Akintola University of Technology Teaching Hospital, PMB 5000, Osogbo, Nigeria. 6. MBChB, FWACS, Directorate of Medical Services, Hospital Management Board, Abere, Osogbo, Osun State, Nigeria. 7. MBChB, FMCPath, Department of Medical Microbiology, Obafemi Awolowo University, Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria. 8. MBBS, Department of Medical Microbiology, Obafemi Awolowo University, Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria. 9. MBChB, Department of Medical Microbiology, Obafemi Awolowo University, Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria. 10. MBBS, MPH, Nigeria Centre for Disease Control, Jabi, Abuja, Nigeria. 11. BPharm MSc, World Health Organization, PMB 2861, Abuja, Nigeria. 12. MD, World Health Organization Regional Office for Africa, P.O. Box 06, Brazzaville, Congo.
Abstract
INTRODUCTION: In order to inform sub-national action plan for control of antimicrobial resistance (AMR) and benchmark interventions to improve antibiotic use, it is essential to define situations on antibiotic use using standardized tools. We sought to assess quality of antimicrobial prescription across all government healthcare facilities with capacities for in-patient care in the first of the 36 states in Nigeria as part of ongoing state-wide situation analysis on AMR. METHODS: A survey was conducted between 10-27 June 2019 using the WHO methodology for point prevalence survey on antibiotic use in hospitals. Data was collected from hospital administrators and records of hospitalized patients. Data analysis was done using Microsoft Excel 2010 (Redmond Washington). RESULTS: Prevalence of antibiotic use amongst all 321 included patients was 76.6% (246/321). Of all indications recorded, the highest was surgical prophylaxis (96/260, 36.9%) for which there were multiple doses beyond 24 hours in almost all cases (91/96, 94.8%). The largest volume of prescribing took place in the surgical wards, and the most common prescriptions were metronidazole (142/564, 25.2%), cefuroxime (104/564, 18.4%), and ceftriaxone (77/564, 13.7%). Overall, 46.3% of the antibiotics used belong to Access group, 53.5% to watch and only 0.2% to Reserve. Treatment in almost all instances 544/563 (96.6%) was empiric. CONCLUSIONS: The majority of patients received multiple antibiotics mostly without compliance to guidelines. There was low prescribing of Access antibiotics and excessive use of antibiotics in the Watch group. Antibiotics were used most commonly for surgical prophylaxis but inappropriately. Inappropriate use of antibiotics in this study underscores the crucial need for an action plan incorporating antimicrobial stewardship. GERMS.
INTRODUCTION: In order to inform sub-national action plan for control of antimicrobial resistance (AMR) and benchmark interventions to improve antibiotic use, it is essential to define situations on antibiotic use using standardized tools. We sought to assess quality of antimicrobial prescription across all government healthcare facilities with capacities for in-patient care in the first of the 36 states in Nigeria as part of ongoing state-wide situation analysis on AMR. METHODS: A survey was conducted between 10-27 June 2019 using the WHO methodology for point prevalence survey on antibiotic use in hospitals. Data was collected from hospital administrators and records of hospitalized patients. Data analysis was done using Microsoft Excel 2010 (Redmond Washington). RESULTS: Prevalence of antibiotic use amongst all 321 included patients was 76.6% (246/321). Of all indications recorded, the highest was surgical prophylaxis (96/260, 36.9%) for which there were multiple doses beyond 24 hours in almost all cases (91/96, 94.8%). The largest volume of prescribing took place in the surgical wards, and the most common prescriptions were metronidazole (142/564, 25.2%), cefuroxime (104/564, 18.4%), and ceftriaxone (77/564, 13.7%). Overall, 46.3% of the antibiotics used belong to Access group, 53.5% to watch and only 0.2% to Reserve. Treatment in almost all instances 544/563 (96.6%) was empiric. CONCLUSIONS: The majority of patients received multiple antibiotics mostly without compliance to guidelines. There was low prescribing of Access antibiotics and excessive use of antibiotics in the Watch group. Antibiotics were used most commonly for surgical prophylaxis but inappropriately. Inappropriate use of antibiotics in this study underscores the crucial need for an action plan incorporating antimicrobial stewardship. GERMS.
Authors: B S C Uzochukwu; M D Ughasoro; E Etiaba; C Okwuosa; E Envuladu; O E Onwujekwe Journal: Niger J Clin Pract Date: 2015 Jul-Aug Impact factor: 0.968
Authors: Pius G Horumpende; Stephen E Mshana; Elise F Mouw; Blandina T Mmbaga; Jaffu O Chilongola; Quirijn de Mast Journal: Antimicrob Resist Infect Control Date: 2020-09-07 Impact factor: 4.887