A point prevalence survey of antimicrobial prescribing in four Nigerian Tertiary Hospitals

Oduyebo, OO; Olayinka, AT; Iregbu, KC; Versporten, Ann; Goossens, Herman; Nwajiobi-Princewill, PI; Jimoh, Olanrewaju; Ige, Oluwafemi Temidayo; Aigbe, AI; Ola-Bello, O.I.; Aboderin, AO; Ogunsola, F.T.

doi:10.4103/atp.atp_38_17

Cited by 58 publications

(83 citation statements)

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“…Overall, nitroimidazoles, third generation cephalosporins and fluoroquinolones were the most commonly prescribed antibiotic groups. This was similar to previous findings in Southern Nigeria [10,11]. In addition, metronidazole, ciprofloxacin, ceftriaxone, and amoxicillin clavulanate were the most used antibiotics among the surveyed patients.…”

Section: Discussionsupporting

confidence: 90%

“…In addition, metronidazole, ciprofloxacin, ceftriaxone, and amoxicillin clavulanate were the most used antibiotics among the surveyed patients. Again, this was consistent with the studies conducted in the southern parts of Nigeria [10,11], but was inconsistent with the results in neighboring African countries including Ghana and Benin [8,16]. These inconsistencies could be explained by differences in antimicrobial resistance patterns and empirical antimicrobial treatment recommendations between the countries.…”

Section: Discussionsupporting

confidence: 65%

“…In Nigeria, studies showed that the prevalence of antibiotic use among hospitalized patients ranged from 62.4 to 78.2% [9][10][11]. Community acquired infection was the most common indication and third generation cephalosporin and nitro-imidazole were the most commonly prescribed antibiotics [9][10][11], however, most of the studies were conducted in a single tertiary healthcare center in the southern part of Nigeria. There is limited data describing the rate and indications for the use of antibiotics among hospitalized patients in Northern Nigeria.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Abubakar

2020

BMC Infect Dis

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Background: The evaluation of antibiotic use among hospitalized patients is a primary step required to design antibiotic stewardship intervention. There is paucity of data describing antibiotic use in hospitals across Northern Nigeria. This study evaluates the prevalence and indications for antibiotic use among inpatients in three acute care hospitals. Methods: A point-prevalence survey was conducted among patients in the wards before or at 8.00 a.m. on the day of the survey, using the point-prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals protocol. The survey was conducted between April and May 2019. The medical records of the patients were reviewed by a clinical pharmacist with the support of physicians and nurses.Results: Overall, 80.1% (257/321) of the patients used at least one antibiotic on the day of the survey. The prevalence of antibiotic use ranged from 72.9% in obstetrics and gynecology to 94.6% in pediatric medical specialty. Community acquired infections (38.7%) and surgical antibiotic prophylaxis (22.5%) were the most common indications. Surgical antibiotic prophylaxis was used or scheduled to be used for more than a day in all the cases. Metronidazole (30.5%), ciprofloxacin (17.1%), ceftriaxone (16.8%), amoxicillin-clavulanate (12.5%) and gentamicin (11.8%) were the most commonly prescribed antibiotics. Overall, broad spectrum antibiotics represented one-third of all the prescriptions. The change of initial antibiotic prescription was reported in one-third of the patients and the reasons include a switch to oral antibiotic (28.5%), escalation (4.5%) and de-escalation (3.6%). Of the 257 patients with an antibiotic prescription, 6.2% had redundant antibiotic combinations. Conclusion:The prevalence of antibiotic use was high with one in three prescriptions having a broad spectrum antibiotic. Prolonged use of surgical antibiotic prophylaxis and redundant antibiotic combination were observed. Antimicrobial stewardship interventions are recommended in order to reduce the use of antibiotics and promote appropriate antibiotics prescribing.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

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Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Abubakar

2020

BMC Infect Dis

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“…Empirical antibiotic use is widely reported in literature either in the form of self-medication or irrational use in healthcare facilities. Some studies have reported that up to 50% of antibiotic prescriptions may be in the form of empirical prescriptions [41]. Microbial sensitivity results are rarely used in many health facilities because of poor healthcare infrastructure and paucity of qualified manpower [42,43].…”

Section: Introductionmentioning

confidence: 99%

“…Microbial sensitivity results are rarely used in many health facilities because of poor healthcare infrastructure and paucity of qualified manpower [42,43]. In many healthcare facilities where laboratory services are available, antibiotic prescriptions are not routinely based on microbial sensitivity results a common cause of irrational use [26,41,44]. Many antibiotic prescription studies have reported both high levels of irrational use and an increasing level of resistance to commonly used antibiotics [23,45].…”

Section: Introductionmentioning

confidence: 99%

Empirical Antibiotic Prescription Pattern among Patients in a Nigerian Tertiary Hospital, is There Evidence of Irrationality?

Paul

Abdulmalik

2019

JAMMR

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Background: Resistance to antibiotics is spreading rapidly around the world with its associated morbidity and mortality. Infections are becoming increasingly difficult to treat resulting in increased cost of medical care. In low income countries with high infectious disease burden, antibiotic resistance is reported to be accelerated by irrational prescriptions in health facilities. In the absence of adequate resources, many clinicians engage in empirical antibiotic prescriptions some of which their appropriateness is questionable. There is need for laboratory evidence to justify empirical antibiotic use in the light of increasing resistance to commonly prescribed antibiotics. Aims: This study aims to determine empirical antibiotic prescription pattern and to determine rationality using resistance profile of common bacterial isolates in hospitals. Methods: Antibiotic prescriptions in the NHIS department and antibiogram records were obtained from pharmacy and laboratory records respectively. Analysis was carried out using descriptive statistics and comparison between antibiotics prescribed and their respective resistance pattern were compared to determine rationality. Results and Discussion: The Penicillins and Quinolones were the most prescribed class of antibiotics and resistance range between 30 – 90% and 3 – 23% respectively. Resistance to other antibiotics was high thus making empirical prescriptions irrational in most of the cases. These findings have been consistently reported in several studies so widespread empirical antibiotic prescriptions are not in tandem with principles of rational drug use. Conclusion: Antibiotic resistance is common among hospital isolates, so there is need to emphasize that prescriptions be based on laboratory evidence of microbial sensitivity.

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QuEChERS Approach for the Analysis of Three Fluoroquinolone Antibiotics in Wastewater: Concentration Profiles and Ecological Risk in Two Nigerian Hospital Wastewater Treatment Plants

Ajibola

Amoniyan

Ekoja

et al. 2020

Arch Environ Contam Toxicol

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A point prevalence survey of antimicrobial prescribing in four Nigerian Tertiary Hospitals

Cited by 58 publications

References 1 publication

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Empirical Antibiotic Prescription Pattern among Patients in a Nigerian Tertiary Hospital, is There Evidence of Irrationality?

QuEChERS Approach for the Analysis of Three Fluoroquinolone Antibiotics in Wastewater: Concentration Profiles and Ecological Risk in Two Nigerian Hospital Wastewater Treatment Plants

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