Antibiotic use in a tertiary healthcare facility in Ghana: a point prevalence survey

Abstract

BackgroundThe global rise and spread of antibiotic resistance is limiting the usefulness of antibiotics in the prevention and treatment of infectious diseases. The use of antibiotic stewardship programs guided by local data on prescribing practices is a useful strategy to control and reduce antibiotic resistance. Our objective in this study was to determine the prevalence and indications for use of antibiotics at the Korle-Bu Teaching Hospital Accra, Ghana.MethodsAn antibiotic point prevalence survey was conducted among inpatients of the Korle-Bu Teaching Hospital between February and March 2016. Folders and treatment charts of patients on admission at participating departments were reviewed for antibiotics administered or scheduled to be administered on the day of the survey. Data on indication for use were also collected. Prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of survey by the total number of patients on admission.ResultsOf the 677 inpatients surveyed, 348 (51.4%, 95% CI, 47.6–55.2) were on treatment with antibiotics. Prevalence was highest among Paediatric surgery where 20/22 patients (90.9%, 95% CI, 70.8–98.9) were administered antibiotics and lowest among Obstetrics patients with 77/214 (36%, 95% CI, 29.5–42.8). The indications for antibiotic use were 245/611 (40.1%) for community-acquired infections, 205/611 (33.6%) for surgical prophylaxis, 129/611 (21.1%) for healthcare associated infections and 33/611 (5.4%) for medical prophylaxis. The top five antibiotics prescribed in the hospital were metronidazole 107 (17.5%), amoxicillin-clavulinic acid 82 (13.4%), ceftriaxone 17(12.1%), cefuroxime 61 (10.0%), and cloxacillin 52 (8.5%) respectively. Prevalence of meropenem and vancomycin use was 12(2%) and 1 (.2%) respectively. The majority of patients 181 (52%) were being treated with two antibiotics.ConclusionThis study indicated a high prevalence of antibiotic use among inpatients at the Korle-Bu Teaching Hospital. Metronidazole was the most commonly used antibiotic; mainly for surgical prophylaxis. There is the need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0299-z) contains supplementary material, which is available to authorized users.

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

“…The prevalence of antibiotic use in the current study was consistent with a similar study conducted in South East Nigeria (78.6%) [10]. The prevalence of antibiotic use among hospitalized patients in Nigeria was higher than other African countries including Ghana (51.4%) [16] and Benin (64.6%) [8], Europe (30.5%) [6], and the United States (49.9%) [7]. The high rate of antibiotic use among hospitalized patients could be attributed to lack of a national antimicrobial guideline to promote rational use of antibiotics in hospital setting.…”

“…The study also found that majority (about 67%) of the patients who used antibiotic on the day of the survey had two or more prescriptions, similar to the result in Ghana [16]. However, the use of multiple antibiotic therapy among hospitalized patients was more than two times higher than Europe's (29.4%) [6].…”

“…In addition, metronidazole, ciprofloxacin, ceftriaxone, and amoxicillin clavulanate were the most used antibiotics among the surveyed patients. Again, this was consistent with the studies conducted in the southern parts of Nigeria [10,11], but was inconsistent with the results in neighboring African countries including Ghana and Benin [8,16]. These inconsistencies could be explained by differences in antimicrobial resistance patterns and empirical antimicrobial treatment recommendations between the countries.…”

Antibiotic resistance in patients with clinical features of healthcare-associated infections in an urban tertiary hospital in Sierra Leone: a cross-sectional study

“…A proportion of patients higher than recorded in other studies in LMICs [21,22] and high-income countries(HICs) [23] used at least one antibiotic prior to enrollment. The high rate of antibiotic use by this cohort could be a predisposing factor to the high levels of resistance observed in this study, although it could also be explained by the effort of service providers to treat the patients' febrile conditions.…”

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

“…In the present study, 77.6% of admitted patients on one single day had consumed at least one antimicrobial. This is much higher than prevalence rates reported in other PPS studies across the world including the Global PPS ( [48]. In Botswana, more than two-thirds of admissions in their PPS study were due to infectious diseases with 40% of those tested were HIV positive [47].…”