Antibiotic use in a district hospital in Kabul, Afghanistan: are we overprescribing?

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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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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‘They eat it like sweets’: A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan

PLoS ONE ◽

10.1371/journal.pone.0260096 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260096

Author(s):

Doris Burtscher ◽

Rafael Van den Bergh ◽

Masood Nasim ◽

Gbane Mahama ◽

Sokhieng Au ◽

...

Keyword(s):

Antibiotic Resistance ◽

Mixed Methods ◽

Health Workers ◽

District Hospital ◽

Antibiotic Use ◽

Healthcare Services ◽

The Body ◽

Mixed Methods Study ◽

Second Phase ◽

Inappropriate Use

Background Antibiotic resistance is a growing public health threat. In Afghanistan, high levels of indiscriminate antibiotic use exist, and healthcare programmes are not informed by understanding of local attitudes towards rational antibiotic use. Médecins Sans Frontières is an international non-governmental organization providing healthcare services to the Ahmad Shah Baba (ASB) District Hospital in Kabul, Afghanistan, since 2009. This mixed-methods study aimed to explore the perceptions and attitudes toward antibiotics among patients, prescribers, and pharmacists in the ASB District hospital outpatient department. Methods and findings Knowledge of antibiotics including their purpose and function, how and why they are used, and drivers for choice of antibiotic was examined at patient, prescriber, and provider-level. The first phase of the study, an exploratory qualitative component using an interpretative approach, was used to inform the second phase, a structured survey. Thirty-six interviews were conducted with 39 participants (21 patients or caretakers and 18 hospital health workers). Three hundred and fifty-one (351) patients and caretakers completed the second phase, the structured survey. This study found that poor knowledge of antibiotics and antibiotic resistance is a driving factor for inappropriate use of antibiotics. Participant perceptions of living in a polluted environment drove the high demand and perceived ‘need’ for antibiotics: patients, doctors and pharmacists alike consider dirty and dusty living conditions as causes of ‘disease’ in the body, requiring antibiotics to ‘clean’ and ‘strengthen’ it. Conclusions Findings highlight the need for strategies to improve awareness and knowledge of the general public, improve practice of doctors and pharmacists, regulate antibiotic dispensing in private pharmacies, and implement antibiotic stewardship in hospitals.

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Point prevalence survey of antimicrobial use in three hospitals in North-Eastern Tanzania

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00809-3 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Pius G. Horumpende ◽

Stephen E. Mshana ◽

Elise F. Mouw ◽

Blandina T. Mmbaga ◽

Jaffu O. 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 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 h 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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The Effect of a School Education Program on Antibiotic Use in Some First Nation Communities

PsycEXTRA Dataset ◽

10.1037/e509012013-163 ◽

2004 ◽

Author(s):

Harry Hodes

Keyword(s):

Education Program ◽

Antibiotic Use ◽

School Education ◽

First Nation

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HUBUNGAN KUALITAS KEHIDUPAN KERJA TERHADAP KINERJA PERAWAT PELAKSANA

Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal ◽

10.32583/pskm.9.4.2019.413-420 ◽

2019 ◽

Vol 9 (4) ◽

pp. 413-420

Author(s):

Amella Gusty ◽

Dachriyanus Dachriyanus ◽

Leni Merdawati

Keyword(s):

District Hospital ◽

Simple Random Sampling ◽

Work Life ◽

Quality Of Work Life ◽

P Value ◽

Work Context ◽

Cross Sectional ◽

Quality Of Work ◽

The Relationship

Kinerja perawat merupakan hasil yang dicapai dalam melaksanakan asuhan keperawatan di rumah sakit. Terciptanya asuhan keperawatan yang optimal sangat diperlukan dukungan dari pihak rumah sakit salah satunya adalah menciptakan kualitas kehidupan kerja baik bagi perawat. Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas kehidupan kerja terhadap kinerja perawat pelaksana di RSUD Teluk Kuantan. Jenis penelitian kuantitatif dengan pendekatan cross sectional. Jumlah sampel 120 responden yang diperoleh melalui proportionate simple random sampling. Hasil penelitian menunjukkan kualitas kehidupan kerja perawat RSUD Teluk Kuantan berada pada kategori sedang, kinerja perawat berada pada kategori kurang baik. Berdasarkan analisis kedua variabel teridentifikasi bahwa tidak ada hubungan antara kualitas kehidupan kerja dengan kinerja perawat pelaksana dengan p value 0,817. Dimensi work context merupakan komponen yang memiliki hubungan dengan kinerja perawat pelaksana dengan p value 0,008, dimensi work life tidak berhubungan secara signifikan dengan kinerja perawat. Kesimpulan penelitian diketahui tidak ada hubungan antara kualitas kehidupan kerja dengan kinerja perawat pelaksana. Ada hubungan dimensi work context dengan kinerja perawat pelaksana. Tidak ada hubungan dimensi work life dengan kinerja perawat. Kata kunci: kualitas kehidupan kerja, kinerja, perawat pelaksana THE RELATIONSHIP BETWEEN THE QUALITY OF WORK LIFE AND THE PERFORMANCE OF IMPLEMENTERS NURSES ABSTRACT Nurse performance is the result achieved in implementing nursing care in a hospital. The creation of optimal nursing care is very much needed support from the hospital, one of which is to create a good quality of work life for nurses. This study aims to determine the relationship between the quality of work life and the performance of nurses at the Kuantan District Hospital. This type of quantitative research with cross sectional approach. The number of samples of 120 respondents obtained through proportionate simple random sampling. The results showed that the quality of work life of nurses at the Kuantan District Hospital was in the medium category, the nurses' performance was in the unfavorable category. Based on the analysis of the two variables, it was identified that there was no relationship between the quality of work life with the performance of implementing nurses with a p value of 0.817. The work context dimension is a component that has a relationship with the performance of nurses implementing with p value 0.008, the dimension of work life does not significantly correlate with nurse performance. The conclusion of the research is that there is no relationship between the quality of work life and the performance of the implementing nurses. There is a relationship between the dimensions of the work context and the performance of the nurses. There is no relationship between the dimensions of work life and nurse performance. Keywords: quality of work life, performance, implementers nurse

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