Rational Use of Antibiotics – A Point Prevalence Study Carried out at a Tertiary Hospital in South-South Nigeria
International Journal of TROPICAL DISEASE & Health,
Introduction: The burden of antibiotic resistance in the hospitals and communities is progressively worsening hence the critical need to put into practice all the key components of rational use of antibiotics in our daily patient interactions. This paper aims to highlight the problem of antibiotic resistance, the importance of rational use of antibiotics and to show an on the spot sketch of the antibiotic use pattern among in-patients in the children wards in a tertiary hospital.
Methodology: A brief review of the existing literature on antibiotic resistance and the rational use of antibiotics was done. A one-day cross-sectional point prevalence study was conducted in the children wards in UPTH and all children receiving antibiotics on that day, identified. The prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of the survey by the total number of patients on admission. Data were presented in percentages using pie and bar charts.
Results: There were a total of 40 children on admission in the paediatric wards with a Male: Female ratio of 1.2:1. 34 (85.0%) of the children on admission were receiving at least one antibiotic. The most common route of administration of the antibiotics was the intravenous route (94.1%). The five most commonly prescribed antibiotics in the children medical wards and the emergency ward were Ceftriaxone, Gentamycin, Cefuroxime, Metronidazole and Crystalline penicillin, while the five most common antibiotics prescribed in the special care baby unit were Gentamycin, Ceftazidime, Ceftriaxone, Metronidazole and Ofloxacin. Only 10 (29.4%) out of children receiving antibiotics had a microbiology culture result available, and 4 were receiving antibiotics in line with the culture sensitivity pattern. Two (5.9%) children had a multidrug-resistant infection.
Conclusion: This study showed a high prevalence of antibiotic use among inpatients and low utilization of microbiology culture results in the choice of antibiotics in a tertiary hospital in South-south Nigeria. Antibiotic prescribing patterns among healthcare workers should be improved upon by training and retraining of personnel as well as strict adherence to antibiotic prescription guidelines.
- Antibiotic resistance
- rational use
How to Cite
Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews. 2017;(2). Art. No.: CD003543. DOI: 10.1002/14651858.CD003543.pub4.
Irawati L, Alrasheedy AA, Hassali MA, Saleem F. Low-income community knowledge, attitudes and perceptions regarding antibiotics and antibiotic resistance in Jelutong District, Penang, Malaysia: a qualitative study. BMC Public Health. 2019;19:1292.
Mili´c N, Milanovic M, Leti´c NG; Sekuli´c, MT, Radoni´c J, Mihajlovi´c I, Miloradov V. Occurrence of antibiotics as emerging contaminant substances in the aquatic environment. Int. J. Environ. Health Res. 2013;23:296–310.
Martínez JL. Natural antibiotic resistance and contamination by antibiotic resistance determinants: The two ages in the evolution of resistance to antimicrobials. Front. Microbiol. 2012:3.
Col NF, O'Connor RW. Estimating worldwide current antibiotic usage: report of Task Force 1. Rev Infect Dis. 1987; 9:232–243.
World Health Organization. Antimicrobial resistance: global report on surveillance.Geneva: World Health Organization; 2014.
Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA). World Journal of Emergency Surgery. 2016;11(33):1-32.
Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010;10:597–602.
World health organization (WHO). Global strategy for containment of antimicrobial resistance; 2001.
Oduyebo OO, Olayinka AT, Iregbu KC, Versporten A, Goossens H, Nwajiobi-Princewill PI, et al. A point prevalence survey of antimicrobial prescribing in four Nigerian Tertiary Hospitals. Ann Trop Pathol. 2017;8:42-46.
Omoyibo EE, Oladele AO, Ibrahim MH, Adekunle OT. Antibiotic Susceptibility of Wound Swab Isolates in a Tertiary Hospital in Southwest Nigeria. Ann Afr Med. 2018; 17(3):110–116.
Enato EFO, Uwaga CF. Profile of antimicrobial drug use patterns in a Nigerian metropolitan city. Int J Health Res. 2011;4(1):37-44.
Umeokonkwo CD, Madubueze UC, Onah CK, Okedo-Alex IN, Adeke AS, Versporten A, et al. Point prevalence survey of antimicrobial prescription in a tertiary hospital in South-East Nigeria: A call for improved antibiotic stewardship. J Glob Antimicrob Resist. 2019;17:291–295.
Kiguba R, Karamagi C, Bird SM. Extensive antibiotic prescription rate among hospitalized patients in Uganda: but with frequent missed-dose days. J Antimicrob Chemother 2016;71:1697–1706.
Sviestina I, Mozgis D. Observational Study of Antibiotic Usage at the Children’s Clinical University Hospital in Riga, Latvia. Medicina. 2018;54(74):1-13.
Rosenthal VD, Maki DG, Graves N. The International Nosocomial Infection Control Consortium (INICC): goals and objectives, description of surveillance methods, and operational activities. Am J Infect Control. 2008;36:1–12.
Labi A-K, Obeng-Nkrumah N, Nartey ET, Bjerrum S, Adu-Aryee NA, Ofori-Adjei YA, et al. Antibiotic use in a tertiary healthcare facility in Ghana: a point prevalence survey. Antimicrob Resist Infect Control. 2018;7(1):15.
Ahoyo TA, Bankolé HS, Adéoti FM, Gbohoun AA, Assavèdo S, Amoussou-Guénou M, et al. Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012. Antimicrob Resist Infect Control. 2014;3(1):17.
Magill S, Edwards JR, Beldavs ZG, Dumyati G, Janelle SJ, Kainer MA, et al. Emerging infections program healthcare-associated infections and antimicrobial use prevalence survey team. Prevalence of antimicrobial use in US acute care hospitals, May-September 2011. JAMA. 2014;312(14):1438–1446.
Cyriac JM, James E. Switch over from intravenous to oral therapy: a concise overview. J Pharmacol Pharmacother. 2014;5:83.
Fadare J, Olatunya O, Oluwayemi O, Ogundare O. Drug prescribing pattern for under-fives in a paediatric clinic in South-Western Nigeria. Ethiop J Health Sci. 2015;25(1):73-78.
Okeke IN, Peeling RW, Goossens H, Auckenthaler R, Olmsted SS, de Lavison JF, et al. Diagnostics as essential tools for containing antibacterial resistance. Drug Resist Updat. 2011;14:95–106.
Berkelman R, Cassell, G, Specter S, Hamburg M, Klugman K. The "Achilles heel" of global efforts to combat infectious diseases. Clin Infect Dis. 2006;1:1503-1504.
Lee C, Lee JH, Kang L, Jeong BC, Lee SH. Educational Effectiveness, Target, and Content for Prudent Antibiotic Use. BioMed Research International. 2015;214021:1-13.
Ajemigbitse AA, Omole MK, Ezike NC, Erhun WO. Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital. Journal of basic and clinical pharmacy. 2014;5(1):7-14.
Dubberke ER, Fraser VJ. Cycling and other strategies to slow and reverse antibiotic resistance. https://www.medscape.com/viewarticle/494369_print.
Gelband H, Delahoy M. Policies to Address Antibiotic Resistance in Low- and Middle-Income Countries National and International Action on Antimicrobial Resistance. The centre for disease dynamics, Economics and Policy, Discussion Paper; 2014.
Ofori-Asenso R, Brhlikova P, Pollock AM. Prescribing indicators at primary health care centres within the WHO African region: a systematic analysis (1995–2015). BMC Public Health. 2016;16(724):1-14.
Abstract View: 492 times
PDF Download: 266 times