Evaluation of Antibiotic Use in Medical Ward of Fitche District Hospital, North Showa Zone, Oromia Region, Ethiopia

Abstract Background: Antimicrobial resistance (AMR) is one of the most urgent global health threats with low-resource countries being disproportionately affected. Targeted interventions require insight in antibiotic prescription practices. A point prevalence survey (PPS) is a well-known tool to get insight in antibiotic dispensing practices in hospitals and identify areas for improvement. Here, we describe the results of a PPS performed in a tertiary, regional and district hospital in Kilimanjaro region in Tanzania. Methods: A PPS was performed in the Kilimanjaro Christian Medical Centre (KCMC; tertiary hospital), Mawenzi (regional) and St. Joseph (district) hospital in November and December 2016. Antibiotic use in all patients admitted more than 24 hours and those undergoing surgery was recorded. All clinical wards were included except the pediatrics. Data from a single ward were collected on the same day. Results: A total of 399 patients were included in the PPS: 232 patients from KCMC, 94 from Mawenzi hospital and 73 patients from St. Joseph hospital. Overall prevalence of antibiotic use was 44.0%: 38% in KCMC, 59% in Mawenzi and 63% in St. Joseph. Ceftriaxone (n=94, 29.8%), metronidazole (n=79, 23.9%) and other antibiotics belonging to the penicillin class (n=89, 28.3%) were most commonly prescribed. Antibiotics prescribed for surgical prophylaxis were continued for more than 3 days in 57% of cases.Conclusion: Our study shows a rate of broad-spectrum antibiotic use in Tanzanian hospitals and prolonged surgical antibiotic prophylaxis being a common practice. PPS is an important tool to improve future antibiotic use in Tanzania hospitals.

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Point Prevalence survey of antimicrobial use in three hospitals in North-eastern Tanzania

10.21203/rs.3.rs-28855/v1 ◽

2020 ◽

Author(s):

Pius Gerald Horumpende ◽

Stephen Eliatosha Mshana ◽

Elise F Mouw ◽

Blandina Theophil Mmbaga ◽

Jaffu Othniel Chilongola ◽

...

Keyword(s):

District Hospital ◽

Antibiotic Use ◽

Tertiary Hospital ◽

Point Prevalence ◽

Prevalence Survey ◽

Targeted Interventions ◽

Prescription Practices ◽

Point Prevalence Survey ◽

Surgical Antibiotic Prophylaxis ◽

Kilimanjaro Christian Medical Centre

Abstract Abstract Background : Antimicrobial resistance (AMR) is one of the most urgent global health threats with low-resource countries being disproportionately affected. Targeted interventions require insight in antibiotic prescription practices. A point prevalence survey (PPS) is a well-known tool to get insight in antibiotic dispensing practices in hospitals and identify areas for improvement. Here, we describe the results of a PPS performed in a tertiary, regional and district hospital in Kilimanjaro region in Tanzania. Methods: A PPS was performed in the Kilimanjaro Christian Medical Centre (KCMC; tertiary hospital), Mawenzi (regional) and St. Joseph (district) hospital in November and December 2016. Antibiotic use in all patients admitted more than 24 hours and those undergoing surgery was recorded. All clinical wards were included except the pediatrics. Data from a single ward were collected on the same day. Results : A total of 399 patients were included in the PPS: 232 patients from KCMC, 94 from Mawenzi hospital and 73 patients from St. Joseph hospital. Overall prevalence of antibiotic use was 44.0%: 38% in KCMC, 59% in Mawenzi and 63% in St. Joseph. C eftriaxone (n=94, 29.8%), metronidazole (n=79, 25.1%) and other antibiotics belonging to the penicillin class (n=89, 28.3%) were most commonly prescribed. Antibiotics prescribed for surgical prophylaxis were continued for more than 3 days in 57% of cases. Conclusion: Our study shows a rate of broad-spectrum antibiotic use in Tanzanian hospitals and prolonged surgical antibiotic prophylaxis being a common practice. PPS is an important tool to improve future antibiotic use in Tanzania hospitals.

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Audit of Early Mortality among Patients Admitted to the General Medical Ward at a District Hospital in Botswana

Annals of Global Health ◽

10.5334/aogh.1354 ◽

2019 ◽

Vol 85 (1) ◽

Author(s):

Colleen Kershaw ◽

Margaret Williams ◽

Saikiran Kilaru ◽

Rebecca Zash ◽

Kitenge Kalenga ◽

...

Keyword(s):

District Hospital ◽

Early Mortality ◽

Medical Ward ◽

General Medical Ward

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Using a period incidence survey to compare antibiotic use in children between a university hospital and a district hospital in a country with low antimicrobial resistance: a prospective observational study

BMJ Open ◽

10.1136/bmjopen-2018-027836 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027836

Author(s):

Christian Magnus Thaulow ◽

Hege Salvesen Blix ◽

Beate Horsberg Eriksen ◽

Ingvild Ask ◽

Tor Åge Myklebust ◽

...

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

District Hospital ◽

Antibiotic Use ◽

University Hospital ◽

Adherence Rate ◽

National Guidelines ◽

Registration Period ◽

Tract Infections ◽

Systemic Antibiotics

ObjectivesTo describe and compare antibiotic use in relation to indications, doses, adherence rate to guidelines and rates of broad-spectrum antibiotics (BSA) in two different paediatric departments with different academic cultures, and identify areas with room for improvement.DesignProspective observational survey of antibiotic use.SettingPaediatric departments in a university hospital (UH) and a district hospital (DH) in Norway, 2017. The registration period was 1 year at the DH and 4 months at the UH.Participants201 children at the DH (mean age 3.8: SD 5.1) and 137 children at the UH (mean age 2.0: SD 5.9) were treated with systemic antibiotics by a paediatrician in the study period and included in the study.Outcome measuresMain outcome variables were prescriptions of antibiotics, treatments with antibiotics, rates of BSA, median doses and adherence rate to national guidelines.ResultsIn total, 744 prescriptions of antibiotics were given at the UH and 638 at the DH. Total adherence rate to guidelines was 75% at the UH and 69% at the DH (p=0.244). The rate of treatments involving BSA did not differ significantly between the hospitals (p=0.263). Use of BSA was related to treatment of central nervous system (CNS) infections, patients with underlying medical conditions or targeted microbiological treatment in 92% and 86% of the treatments, at the UH and DH, respectively (p=0.217). A larger proportion of the children at the DH were treated for respiratory tract infections (p<0.01) compared with the UH. Children at the UH were treated with higher doses of ampicillin and cefotaxime (p<0.05) compared with the DH.ConclusionOur results indicate that Norwegian paediatricians have a common understanding of main aspects in rational antibiotic use independently of working in a UH or DH. Variations in treatment of respiratory tract infections and in doses of antibiotics should be further studied.

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Clostridium Difficile in Urology

Annals of The Royal College of Surgeons of England ◽

10.1308/003588408x242358 ◽

2008 ◽

Vol 90 (1) ◽

pp. 36-39 ◽

Cited By ~ 4

Author(s):

M Hossain ◽

TJ Crook ◽

SR Keoghane

Keyword(s):

Clostridium Difficile ◽

Elderly Care ◽

The Elderly ◽

Antibiotic Use ◽

Stool Culture ◽

Medical Ward ◽

Positive Stool ◽

Surgical Ward ◽

Significant Difference ◽

Care Ward

INTRODUCTION The objective was to determine the incidence of Clostridium difficile infection in a UK urology ward from 2000 to 2005, and correlate and compare the data with other specialty wards and national figures. PATIENTS AND METHODS Urology patients with a positive stool culture for C. difficile between 2000 and 2005 were identified from a hospital database. The medical records of these patients were reviewed and data such as antibiotic use, urological diagnosis and elective/emergency status of the patient were recorded and analysed. The number of C. difficile cases on an elderly care ward, an acute medical ward and an acute surgical ward were also recorded for this period. Data on the number of admissions and occupied bed-days on all 4 wards were compared. RESULTS There were 33 cases of C. difficile on the urology ward between 2000 and 2005. The incidence of this infection varied between 10.2 and 48.4 cases per 10,000 patient episodes (mean 21.0). There was a significant difference between the number of C. difficile cases per 1000 patient days between the urology ward and the acute medical ward (P = 0.002) and the elderly care ward (P = 0.03). CONCLUSIONS There is no evidence to suggest that there has been an increase in the incidence of C. difficile in a UK urology ward. The rates on the urology ward were lower than the national average, and significantly lower than those rates on an acute medical ward and an elderly care ward. There is a 0.21% chance of a patient testing positive for C. difficile during their stay on a urology ward.

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