Background: Antimicrobial resistance is an increasingly serious threat to global public health. While the use of antibiotics is an important contributing factor, there are gaps regarding this in our region. This study aimed to describe the use of nine broad spectrum antibiotics among in-patients of The Nairobi Hospital (TNH) so as to identify opportunities for quality improvement.Methods: This was a retrospective review of the use of meropenem, ertapenem, imipenem, cefepime, piperacillin, gentamicin, amikacin, vancomycin and teicoplanin among in-patients of TNH from 1st January 2018 to 31st March 2018. Demographic and clinical data of all in-patients who were prescribed these antibiotics during the study period were retrieved from patient files.Results: There were 301 study participants with a median age (range) of 30years (1day-74years), of whom 161 (53.5%) were male. More than half of the participants were admitted for less than one week and had at least one co-morbidity. Meropenem was the most commonly prescribed study antibiotic 123 (40.9%) followed by amikacin 89 (29.6%). Respiratory tract infections 125 (41.5%) were the predominant indications. Meropenem had the longest mean duration of administration, 6.5days while the aminoglycosides were administered for a relatively shorter duration of about 4.8days. Cultures were done on 187 (62.1%) patients though it is only samples of 45 patients that grew an organism, E. coli and Klebsiella sp being the most frequently isolated organisms.Conclusions: There’s a need to strongly intensify implementation of restriction strategies for Meropenem use and introduction of education programs on antimicrobial stewardship targeting all prescribers.

COVID-19 is a novel viral disease with little known about its management. The Nairobi Hospital (TNH) has been involved in managing these patients. This study sought to describe the patients admitted in the hospital due to COVID-19, their management and outcomes. This was a retrospective review of COVID-19 patients admitted at TNH between March and October 2020. Demographic and clinical data, pharmacological management and outcomes of these patients was retrieved from the hospital electronic records, and analyzed. Results revealed that there were 326 study participants with a mean age (s.d.) of 47.1 (15.5) years, of whom 221(67.8%) were male. Those that were critically ill were 55(16.9%), while 186(57.1%) had mild/moderate disease. More than half of the participants had at least one co-morbidity, with hypertension and diabetes being predominant. Remdesivir was the commonest investigational drug and was administered to 39 patients. The patients were mainly managed with paracetamol (83.3%), ascorbic acid (79.8%), anticoagulants (64.4%), antihistamines and cough syrups (53.7%). Dexamethasone was the steroid of choice, having been used in 44% of the patients. Antibiotics were administered to 157 (48.4%) of the patients with Levofloxacin being the most prescribed. The mortality rate was 10% and was significantly associated with advanced age, having multiple comorbidities and severe illness. It was thus understood that management of COVID-19 inpatients at TNH was mainly supportive. There's need to emphasize on prevention measures especially among the elderly and those with multiple comorbidities.