Rational Use of Antibiotics – A Point Prevalence Study Carried out at a Tertiary Hospital in South-South Nigeria

Abstract

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.

Point Prevalence Surveys of Antibiotic Prescribing in Children at a Tertiary Hospital in a resource constraint, low- income sub-Saharan African country.

“…In this study, the overall prevalence of antibiotic use (AMU) in children (both neonates and older children) in this study was high, similar to other studies in Nigeria and Africa (32,38), however, higher than published rates for Europe (39,40). Therefore, if we are to gain meaningful control of antimicrobial use, we must focus on children, neonates in particular.…”

“…Point prevalence surveys of antibiotic use in Nigeria has shown a high rate of antimicrobial prescribing (> 80%) in children, with more than 90% of antibiotics given by the intravenous route (31)(32)(33). There is an urgent need to implement antimicrobial stewardship program which has been shown to be very effective at reducing unnecessary antibiotic use, reducing morbidity and mortality and limiting the development of multidrug-resistant organisms (MDROs).…”

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

“…However, all informational sources and papers have been extensively referenced. References [ 255 , 256 , 257 , 258 , 259 , 260 , 261 , 262 , 263 , 264 , 265 , 266 ] are cited in Supplementary Materials file .…”

Point Prevalence Surveys of Antibiotic Prescribing in Children at a Tertiary Hospital in a resource constraint, low- income sub-Saharan African country.

“…Antimicrobial resistance can be curtailed when there is judicious and effective use of antibiotics. The Global PPS can be used to monitor rates of antimicrobial prescribing in hospitalized adults, children and neonates and identify targets to improve quality of antimicrobial use/prescribing (27,32). The Global -PPS was used in this study to determine the rates of antibiotic use, antibiotic therapy and prophylaxis and patterns of antibiotic use over a period of four years from 2015 to 2019.…”

“…Point prevalence surveys of antibiotic use in Nigeria has shown a high rate of antimicrobial prescribing (> 80%) in children, with more than 90% of antibiotics given by the intravenous route (31)(32)(33). There is an urgent need to implement antimicrobial stewardship program which has been shown to be very effective at reducing unnecessary antibiotic use, reducing morbidity and mortality and limiting the development of multidrug-resistant organisms (MDROs).…”