Antimicrobial use among paediatric inpatients in a Nigerian tertiary hospital: A three-year point prevalence survey

Abstract

Aim Antimicrobials are among the most widely prescribed therapeutic agents among paediatric population. Irrational use of these agents increases the risk of antimicrobial resistance. We described the prevalence and pattern of antimicrobial use among paediatric inpatients from 2017 to 2019. Subject and Method The study was a repeated point prevalence survey over a 3-year period using the global point prevalence standardized tools among all paediatric inpatients. The prevalence of antimicrobial use, the prescription indicators and patterns of antimicrobial use were estimated. Result Among 191 paediatric inpatients assessed, the 3-year period prevalence antimicrobial use was 85.9% (164/191) with prevalence of 80.6% in 2017, 94.6% in 2018, and 83.6% in 2019. Antimicrobial agents used ranged from one agent (20.1%) to five different agents (5.5%). Parenteral route (66.6%) was the preferred route of administration. The reason for the use of antimicrobial agents (92.6%) and the stop/review date (99.5%) were mostly well documented. Only 4.5% of the antimicrobial use were targeted. There were no antimicrobial guidelines or policy guiding the use of antimicrobial agents, except the national guideline on the treatment of malaria and tuberculosis. Ceftriaxone, a third generation cephalosporin was the most commonly used agent across the period under review. Community-acquired infection was the commonest indication for antimicrobial use. Conclusion Our findings of high antimicrobial prevalence has raised the attention for the need to develop hospital-based antimicrobial guideline and antimicrobial stewardship program to protect the vulnerable children, their contacts and the environment from the impact of antimicrobial resistance.

Pattern of inappropriate antibiotic use among patients in the medical wards of a tertiary hospital in southwest Nigeria

“…It is noteworthy that most of the patients who had inappropriate choice of antibiotics were placed on multiple antibiotics when the guidelines recommended a single antibiotic. This is similar to other studies done in Nigeria which showed high usage of multiple antibiotic therapy (26). The use of, multiple antibiotic therapy, especially those with similar antibiotic spectrum, results in redundant therapy which could lead to increased costs, increased risk of adverse effects and antago-nism and the development of resistance (27).…”

“…Most of the point prevalence surveys of antimicrobial consumption in Nigeria have shown ceftriaxone and metronidazole as the most commonly prescribed antibiotics in tertiary healthcare facilities like ours (13,26). Similarly, a study done in Uganda showed that the most frequently prescribed antibiotics for in-patients were ceftriaxone (66%), metronidazole (41%), co-trimoxazole (27%), ciprofloxacin (19.0%) and amoxicillin (10.0%) (28).…”