Evaluation of ceftriaxone use in the medical ward of Halibet National Referral and teaching hospital in 2017 in Asmara, Eritrea: a cross sectional retrospective study

Abstract

Background Antibiotic resistance due to overuse of antimicrobials is an issue that has been of concern to many health institutions and society in general. Resistant infections have high impact in low income countries since they can’t afford more recent and expensive antibiotics. Studies that evaluate antibiotic use in hospitals are scarce in Eritrea. Ceftriaxone is commonly available in Halibet National Referral and teaching hospital (HNRTH). Resistance to this antibiotic would have a great impact on the hospital since there is no other available third generation cephalosporin or higher classes of antibiotics. Method A retrospective cross sectional design was used to evaluate the use of ceftriaxone in patients admitted to the medical ward in 2017. Clinical card number of inpatients who took ceftriaxone was extracted from the database of the Satellite Pharmacy Department of HNRTH and collected using a standardized data collection form. A descriptive analysis was employed and the Statistical package for social sciences (SPSS), version 20 was used for analysis. Results A total of 120 patients were taking ceftriaxone for various indications. There were 55 (50.5%) males and 54 (49.5%) females. 59.8% of the patients were treated in the range of 0–7 days. The mean age was 56 (SD: 20.7). On average patients were under treatment for 6 days. The proportion of patients taking ceftriaxone was 11.43% out of all admissions in the medical ward. One, two or three antibiotics were co-prescribed with ceftriaxone in 39.4%. The most commonly co-prescribed antibiotic was gentamycin, accounting for 16.4% of the co-administered antibiotics. The most common indications for ceftriaxone were pneumonia, sepsis, TB, and CHF. Ceftriaxone therapy was appropriate in 30 (27.5%) cases and 68 (62.4%) cases were inappropriate in any of the four parameters of assessment used. Conclusion Inappropriate use of ceftriaxone was found to be high in the hospital. This calls for establishment of hospital and national guidelines of antimicrobial treatment. Moreover drug restriction and antibiotic stewardship implementation in the hospital should be sought to prolong the lives of important drugs like ceftriaxone.

Quantitative Analysis of Medication Management and Use in Bima Regional Public Hospital

“…Based on DDD/100 patient-days calculation, two most common antibiotic injections Ceftriaxone Injection 1 g, averaging 21.66 DDD/100 patient-days, and Cefotaxime Injection 1 g with an average of 18.76 DDD/100 patient-days. The high use of ceftriaxone in this study is in line with previously published studies (28) . One of the condiserations of using ceftriaxone is its wide spectrum of antibacterial property, which makes it the primary choice for empirical antibiotics therapy (29) .…”

Antibiotic Prevalence Study and Factors Influencing Prescription of WHO Watch Category Antibiotic Ceftriaxone in a Tertiary Care Private Not for Profit Hospital in Uganda

“…Another retrospective study investigating the trends of admissions and case fatality rates among medical in-patients at a tertiary hospital in Uganda showed that pneumonia, sepsis, and gastroenteritis were among the leading causes of admissions to the infectious disease wards for a period between January 2011 and December 2014 [23]. Our findings are consistent with findings from studies done in Tanzania [15], Ethiopia [2,16], Eriteria [25], the Netherlands [26], and the US [27,28].…”

Bacteria and Antibiotic Susceptibility Patterns of Cerebrospinal Fluid Isolated in Children with Bacterial Meningitis at Sanglah Hospital, Bali from 2016 to 2018

“…However, in an antimicrobial surveillance done by the WHO on all its six regions, the resistance pattern of Escherichia coli (E. coli) to third generation cephalosporins was 50% or more in five regions. All six regions reported Klebsiella pneumonia (K. pneumonia) had developed resistance in 50% or more cases while three regions reported that Neisseria gonorrhoea had developed 25% or more resistance to third generation cephalosporins [13,24] Ceftriaxone is effective as monotherapy in children with meningitis caused by susceptible S. pneumonia, but in our study S. pneumonia was not the major etiology of meningitis. It is also potentially inadequate as empiric therapy of meningitis after neurosurgery because there is an increased likelihood of MRSA, P. aeruginosa and other ceftriaxone-resistant Gram-negative bacilli in this patient population.…”