Antimicrobial use among hospitalized patients: A multi-center, point prevalence survey across public healthcare facilities, Osun State, Nigeria
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Date
2021
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GERMS
Abstract
Introduction In order to inform sub-national action plan for control of antimicrobial resistance
(AMR) and benchmark interventions to improve antibiotic use, it is essential to define situations on
antibiotic use using standardized tools. We sought to assess quality of antimicrobial prescription across
all government healthcare facilities with capacities for in-patient care in the first of the 36 states in
Nigeria as part of ongoing state-wide situation analysis on AMR.
Methods A survey was conducted between 10-27 June 2019 using the
WHO methodology for point
prevalence survey on antibiotic use in hosp itals. Data was collected from hospital administrators and
records of hospitalized patients. Data analysis was done using Microsoft Excel 2010 (Redmond
Washington).
Results Prevalence of antibiotic use amongst all 321 included patients was 76.6% (246/321). Of all
indications recorded, the highest was surgical prophylaxis (96/260, 36.9%) for which there were multiple
doses beyond 24 hours in almost all cases (91/96, 94.8%). The largest volume of prescribing took place in
the surgical wards, and the most common prescriptions were metronidazole (142/564, 25.2%),
cefuroxime (104/564, 18.4%), and ceftriaxone (77/564, 13.7%). Overall, 46.3% of the antibiotics used
belong to Access group, 53.5% to watch and only 0.2% to Reserve. Treatment in almost all instances
544/563 (96.6%) was empiric.
Conclusions The majority of patients received multiple antibiotics mostly without compliance to
guidelines. There was low prescribing of Access antibiotics and excessive use of antibiotics in the Watch
group. Antibiotics were used most commonly for surgical prophylaxis but inappropriately. Inappropriate
use of antibiotics in this study underscores the crucial need for an action plan incorporating
antimicrobial stewardship.
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Aboderin AO, Adeyemo AT, Olayinka AA, Oginni AS, Adeyemo AT, Oni AA, Olabisi OF, Fayomi OD, Anuforo AC, Egwuenu A, Hamzat O, Fuller W. Antimicrobial use among hospitalized patients: A multi-center, point prevalence survey across public healthcare facilities, Osun State, Nigeria. GERMS. 2021;11(4):523-535. doi: 10.18683/germs.2021.1287