A Point Prevalence Survey of Antimicrobial Use at Geita Regional Referral Hospital in North-Western Tanzania.

Lutugera Kihwili, Vitus Silago, Emiliana N Francis, Vicent A Idahya, Zabron C Saguda, Siana Mapunjo, Martha F Mushi, Stephen E Mshana
Author Information
  1. Lutugera Kihwili: Department of Pharmaceutical Sciences, School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania.
  2. Vitus Silago: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania. ORCID
  3. Emiliana N Francis: Ministry of Health, Dodoma P.O. Box 573, Tanzania.
  4. Vicent A Idahya: Geita Regional Referral Hospital, Geita P.O. Box 40, Tanzania.
  5. Zabron C Saguda: Geita Regional Referral Hospital, Geita P.O. Box 40, Tanzania.
  6. Siana Mapunjo: National Multi-Sectoral Coordinating Committee, Ministry of Health, Dodoma P.O. Box 573, Tanzania. ORCID
  7. Martha F Mushi: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania. ORCID
  8. Stephen E Mshana: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania. ORCID

Abstract

We conducted a point prevalence survey (PPS) to determine the prevalence of antibiotic use at Geita Regional Referral Hospital (GRRH) located along the shores of Lake Victoria in north-western Tanzania. This has led to the identification of gaps for improvement. This PPS study was conducted on 9-10 March 2023. Patient-related information, including sociodemographic and clinical data, was collected from medical records. STATA software version 15.0 was used to perform descriptive data analysis. About 94.8% (55/58) patients were on antibiotics with a mean (±SD) prescription of 2 (±0.5) antibiotic agents ranging from 1 to 4 different agents. The commonest indications of the antibiotic prescription were medical prophylaxis 47.3% (26/55) followed by empiric treatment 41.8% (23/55). In total, 110 prescriptions were made, of which metronidazole (25.5%; = 28), ceftriaxone (23.6%; = 26), and ampicillin-cloxacillin (23.6%; = 26) were frequently observed. Only 67.3% ( = 74) of prescriptions complied with Tanzania Standard Treatment Guidelines. Moreover, according to the WHO-AWaRe classification, 50.9%, 23.6%, and 25.5% were under the Access category, Watch category, and Not Recommended category, respectively. The prevalence of antibiotic use among patients admitted to GRRH was high, whereby medical prophylaxis and empiric treatment were the commonest indications for antibiotic prescription. To support rational therapy and antimicrobial stewardship initiatives, we recommend that laboratories in regional hospitals be equipped to conduct sustained routine culture and antimicrobial susceptibility testing.

Keywords

References

  1. Antimicrob Resist Infect Control. 2020 Sep 7;9(1):149 [PMID: 32894182]
  2. Pak J Med Sci. 2014 Jul;30(4):725-30 [PMID: 25097505]
  3. Antimicrob Resist Infect Control. 2022 Dec 24;11(1):164 [PMID: 36566210]
  4. Antimicrob Resist Infect Control. 2020 Jan 13;9(1):13 [PMID: 31956402]
  5. Global Health. 2021 Aug 24;17(1):94 [PMID: 34429128]
  6. J Hosp Med. 2017 Oct 18;13(2):83-89 [PMID: 29073316]
  7. PLoS One. 2009 Sep 16;4(9):e6968 [PMID: 19756138]
  8. Am J Health Syst Pharm. 2013 Feb 1;70(3):195-283 [PMID: 23327981]
  9. Antimicrob Resist Infect Control. 2017 May 15;6:47 [PMID: 28515903]
  10. Antibiotics (Basel). 2021 Sep 17;10(9): [PMID: 34572704]
  11. BMC Prim Care. 2022 Nov 19;23(1):287 [PMID: 36402956]
  12. BMJ Open. 2020 Dec 15;10(12):e042819 [PMID: 33323448]
  13. J Med Life. 2009 Apr-Jun;2(2):114-23 [PMID: 20108530]
  14. EClinicalMedicine. 2023 Mar;57:101848 [PMID: 36776504]
  15. BMC Infect Dis. 2017 Sep 11;17(1):616 [PMID: 28893183]
  16. Antimicrob Resist Infect Control. 2020 Jun 29;9(1):95 [PMID: 32600391]
  17. PLoS One. 2022 Jun 16;17(6):e0270048 [PMID: 35709220]
  18. BMC Med. 2020 Sep 30;18(1):252 [PMID: 32993628]
  19. J Hosp Med. 2023 Jan;18(1):21-32 [PMID: 36372995]
  20. Antibiotics (Basel). 2022 Feb 04;11(2): [PMID: 35203802]
  21. Clin Infect Dis. 2003 Apr 15;36(8):1006-12 [PMID: 12684913]
  22. Cureus. 2021 Aug 6;13(8):e16939 [PMID: 34513508]
  23. Med Clin North Am. 2018 Sep;102(5):805-818 [PMID: 30126572]
  24. Antibiotics (Basel). 2022 Dec 28;12(1): [PMID: 36671246]
  25. JAC Antimicrob Resist. 2021 Feb 08;3(1):dlab008 [PMID: 34223086]

Grants

  1. MR/S004785/1/National Institute for Health Research, Medical Research Council.

Word Cloud

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