A Point Prevalence Survey of Antibiotic Use in 18 Hospitals in Egypt

Abstract

Inappropriate antibiotic use leads to increased risk of antibiotic resistance and other adverse outcomes. The objectives of the study were to determine the prevalence and characteristics of antibiotic use in Egyptian hospitals to identify opportunities for quality improvement. A point prevalence survey was conducted in 18 hospitals in March 2011. A total of 3408 patients were included and 59% received at least one antibiotic, with the most significant use among persons <12 years and intensive care unit patients (p < 0.05). Third generation cephalosporin were the most commonly prescribed antibiotics (28.7% of prescriptions). Reasons for antibiotic use included treatment of community—(27%) and healthcare-associated infections (11%) and surgical (39%) and medical (23%) prophylaxis. Among surgical prophylaxis recipients, only 28% of evaluable cases received the first dose within two hours before incision and only 25% of cases received surgical prophylaxis for <24 h. The prevalence of antibiotic use in Egyptian hospitals was high with obvious targets for antimicrobial stewardship activities including provision of antibiotic prescription guidelines and optimization of surgical and medical prophylaxis practices.

Point prevalence survey of antibiotic use and resistance at a referral hospital in Kenya: findings and implications

“…The most commonly prescribed classes of antibiotics were third generation cephalosporins, imidazole derivatives and broad spectrum penicillins (Figure 3), consistent with a published study in Egypt [16]. The high prevalence of use of third generation cephalosporins in the pediatric ward ( Figure 3) could be attributed to the fact that pediatric patients tend to have a high prevalence of serious infections such as pneumonia and meningitis compared to adults.…”

“…Previous studies in Kenya have found a high prevalence of inpatient antibiotic use at 81.7% [14] and outpatient use at 68.0% to 72.9% of patients [14,15]. Among 18 hospitals in Egypt, the prevalence of antibiotic use was 59% among in-patients [16], and in Nigeria 55.9% of in-patients patients were prescribed antibiotics [8]. In China, the prevalence of antibiotic use among in-patients was 56% in a recent study [17].…”

Broad spectrum antibiotic use among in-patients at a hospital in Nairobi, Kenya

“…The commonest indication for the prescription of our study antibiotics were respiratory infections just like the survey in 18 Egyptian hospitals. 16 Two other studies still found respiratory infections as predominant though at lower prevalence than that in present study. 4,14 As much as the current study population was restricted to those using the select antibiotics, the finding underpins the fact that respiratory infections are common in Kenya and may account for up to half of all hospital admissions in medical and pediatric wards.…”

High Rates of Multi-Drug Resistant Gram-Negative Organisms Associated With Surgical Site Infections in a Teaching Hospital in Ghana

“…We have recently documented long periods of administration of antibiotics in surgical units in Ghana, at all levels of health facilities 9 . Long periods of administration of antibiotics have also been reported in other health facilities in low-and middle-income countries 22,23 .…”