A point prevalence survey of antimicrobial use in two hospitals in Western Kenya

Abstract

Background Information from point prevalence surveys can guide antimicrobial stewardship programs (ASPs). The aim of the present study was to document the use of antimicrobial agents at two hospitals in Western Kenya, namely Bungoma County Referral Hospital (BCRH) and Webuye County Hospital (WCH). Methods The World Health Organization (WHO) Global Point Prevalence Survey (G-PPS) tool was used to collect sociodemographic information of study participants, the type of antimicrobial agents used, indications for antimicrobial use, and diagnostic tests conducted on participants. Files were selected over 24 hours, data was abstracted between July and October 2022, and analysis was carried out on SPSS version 26. Results Among the 361 patients, 223 (61.8%) were on antibiotics. The most common antibiotics used were ceftriaxone (123/237; 34.5%), metronidazole (89/237; 24.9%), and flucloxacillin (36/237; 10.1%). Most (60/237; 25.4%) antibiotics at the WCH were prescribed empirically, while most (46/237; 19.5%) antibiotics at the BCRH were prescribed for prophylaxis. Pneumonia was the leading indication for antibiotic prescriptions at BCRH (18/169, 9.5%), while clinical sepsis (17/169;9.9%) was the leading indication for antibiotic prescriptions at the WCH. 16/237 (6.8%) of the patients who had an antibiotic prescribed were subjected to culture and sensitivity testing, but only 9/16 (81.8%) received the results of the antimicrobial susceptibility tests within the study period. Conclusions Penicillins and Cephalosporins were widely used, prescribing/clinical practices vary from one hospital to another, and microbiological tests were underutilized in the study area. There is a need for enhanced antimicrobial and diagnostic stewardship in the study area.