Drug Use Evaluation (DUE) of Ceftriaxone in Mubende Regional Referral Hospital, Uganda: A Cross-Sectional Survey

Manirakiza, Leonard; Nambasa, Victoria; Nanyonga, Stella; Serwanga, Allan; Alphonsus, Matovu; Denis, Nankola; Ndagije, Helen Byomire

doi:10.26502/jppr.0024

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Afriyie et al 22 reported that the daily dose of ceftriaxone was administered appropriately to all patients; on the contrary, lowest percentage of patients (18.0%) got appropriate daily dose in Manirakiza et al study. 28 The median prevalence of patients with appropriate daily dose of ceftriaxone was 79.8% (IQR: 40.9–91.0%). Shimels et al 31 reported the highest percentage of patients with appropriate duration of ceftriaxone (91.5%), while the lowest prevalence (18.0%) was reported by Negese et al study.…”

Section: Resultsmentioning

confidence: 96%

Appropriate Use of Ceftriaxone in Sub-Saharan Africa: A Systematic Review

Bishaw

Tegegne

Berha

2021

IDR

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Introduction Ceftriaxone is the most frequently used antibiotic for the treatment of various bacterial infections in hospitalized and ambulatory patients. Despite this, inappropriate ceftriaxone use is common. Objective The aim of this review is to assess the appropriate use of ceftriaxone in sub-Saharan African countries. Methods A systematic search was done on PubMed, EMBASE, Cochrane Libraries and Google Scholar for papers published addressing the prescribing pattern and use of ceftriaxone in sub-Saharan Africa. The findings were reported in medians and quartiles. Results A total of 15 articles met the inclusion criteria. Pneumonia and sepsis were the most frequently diagnosed infections in the included studies. The overall median prevalence of appropriate ceftriaxone use is 39.2% (IQR: 29.9–60.9), showing that most of the included studies reported a higher prevalence of inappropriate ceftriaxone use. Although there are a higher number of patients with inappropriate use of ceftriaxone, a relatively higher number of patients got appropriate daily dose (79.8%, IQR: 45.7–89.4) of ceftriaxone than appropriate duration of ceftriaxone (55%, IQR: 52.2–80). Conclusion The review revealed that three in five patients with ceftriaxone got inappropriate ceftriaxone’s dose, frequency or duration. A relatively higher number of patients got appropriate daily dose of ceftriaxone. On the other hand, approximately more than half of the patients got inappropriate duration, too short or too long, of ceftriaxone. Hence, prescribers are recommended to adhere to their country-specific treatment guideline. Moreover, it is highly recommended to either commence or strengthen antimicrobial stewardship program effectively in their healthcare settings.

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Section: Resultsmentioning

confidence: 96%

Appropriate Use of Ceftriaxone in Sub-Saharan Africa: A Systematic Review

Bishaw

Tegegne

Berha

2021

IDR

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“…Although ceftriaxone has been recommended as the drug of choice in the management of severe bacterial infections in Uganda's clinical guidelines, 81% of the prescriptions reviewed indicates inappropriate use of ceftriaxone, increasing the risk of bacterial resistance to ceftriaxone and other cephalosporins (5). In addition, the absence of antibiotic therapy guidelines for management of infected chronic wounds promotes indiscriminate use of cephalosporins, increasing the risk of bacterial resistance to cephalosporins as well as complicating the care of infected chronic wounds (6).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of infected chronic wound isolates and their Minimum inhibitory concentrations against third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda

Martin

Samba

2021

Preprint

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Background: Globally, the burden of infected chronic wounds is likely to increase due to the rising levels of bacterial resistance to antibiotics and non-communicable diseases such as Diabetes mellitus and cancer. Furthermore, the burden of antibiotic resistant strains in infected chronic wounds is likely to increase especially in resource constrained areas like Mbarara regional referral Hospital where the selection of antibiotic therapy does not usually depend on known antibiotic susceptibilities. Therefore the objectives of this study were; (I) to determine the prevalence of infected chronic wounds isolates from patients admitted in the surgical ward of MRRH, Uganda and (II) to determine the MIC of infected chronic wound isolates against the third generation cephalosporins.Method(s): This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Wound swabs were aseptically collected, registered in the laboratory register and depending on the nature of samples; each specimen was inoculated on chocolate, blood, mannitol salt sugar, xylose lysine decarboxylated agar, and MacConkey Agar and incubated at 350C-370C in the incubator. Broth microdilution method was used to test for MIC.The collected data was entered into Microsoft Excel and exported to STATA version 15.0 for statistical analysis. Chi square/Fishers’s Exact test and analysis of variance (ANOVA) tests were used to analyse data for objective 1 and 2 respectively.Results: The most prevalent pathogens isolated were staphylococcus aureus (40.6%,) and Klebsiella spp (29%,) while the least prevalent pathogens were Providencia spp(1.4%, n=1/69) and Enterobacter agglomerans(2.9%, n=2/29). Generally, staphylococcus aureus exhibited the lowest MIC against cefoperazone+sulbactum 2g (Sulcef®) and ceftriaxone 1g (Epicephin®) (4.33±8.41µ/ml and 15.77±23.32µ/ml respectively). However, the differences in mean MIC observed across various groups were not statistically significant (P >0.05).Conclusion: The most prevalent pathogens isolated from patients with infected chronic wounds at the surgical ward of MRRH were Staphylococcus aureus, Klebsiella spp and proteus spp and the most effective third generation cephalosporins were cefoprazone+sulbactam 2g and ceftriaxone 1g (Epicephin®) while the most ineffective antibiotics were cefpodoxime 200mg and cefixime 400mg.

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Chronic wound isolates and their minimum inhibitory concentrations against third generation cephalosporins at a tertiary hospital in Uganda

Tungotyo

Samba

2022

Sci Rep

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Globally, the burden of chronic wound infections is likely to increase due to the rising levels of bacterial resistance to antibiotics. In the United States of America alone, more than 6.5 million chronic wounds with evidence of bacterial infection are diagnosed every year. In addition, the polymicrobial environment in chronic wound infections has been observed from several studies as a risk factor for development of resistance to many antibiotics including the third generation cephalosporins currently used in Mbarara Regional Referral Hospital for treatment of chronic wound infections. Therefore the main objective of this study was to determine the prevalence of chronic wound isolates and their minimum inhibitory concentrations (MIC) against third generation cephalosporins. This study was a cross-sectional descriptive and analytical survey of bacterial isolates from chronic wound infection among 75 study participants admitted in the surgical ward of Mbarara Regional Referral Hospital (MRRH), a tertiary Hospital in Western Uganda. Standard laboratory bacterial culture and identification techniques as well as broth microdilution method were used to isolate, identify pathogens and test for MIC respectively. We found that 69/75 study participants had samples with bacterial growth and the most prevalent pathogens isolated were staphylococcus aureus (40.6%) and Klebsiella spp. (29%). Generally, most isolates were susceptible to cefoperazone + sulbactum 2 g (Sulcef) and ceftriaxone 1 g (Epicephin). The overall prevalence of isolates in chronic wound infection among patients admitted in the surgical ward of MRRH was 92% and the most prevalent isolates were Staphylococcus aureus, Klebsiella species and proteus species respectively. The observed MIC values were higher than the CLSI clinical breakpoint, implying a decreasing trend in susceptibility of chronic wound isolates to third generation cephalosporins.

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Drug Use Evaluation (DUE) of Ceftriaxone in Mubende Regional Referral Hospital, Uganda: A Cross-Sectional Survey

Cited by 4 publications

References 13 publications

Appropriate Use of Ceftriaxone in Sub-Saharan Africa: A Systematic Review

Appropriate Use of Ceftriaxone in Sub-Saharan Africa: A Systematic Review

Prevalence of infected chronic wound isolates and their Minimum inhibitory concentrations against third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda

Chronic wound isolates and their minimum inhibitory concentrations against third generation cephalosporins at a tertiary hospital in Uganda

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