Antimicrobial usage at a large teaching hospital in Lusaka, Zambia
PublisherPublic Library of Science
MetadataShow full item record
AbstractAntimicrobial resistance is a growing global health concern. Antimicrobial stewardship (AMS) curbs resistance rates by encouraging rational antimicrobial use. However, data on antimicrobial stewardship in developing countries is scarce. The objective of this study was to characterize antimicrobial use at the University Teaching Hospital (UTH) in Lusaka, Zambia as a guiding step in the development of an AMS program. This was a cross-sectional, observational study evaluating antimicrobial appropriateness and consumption in non-critically ill adult medicine patients admitted to UTH. Appropriateness was defined as a composite measure based upon daily chart review. Sixty percent (88/146) of all adult patients admitted to the general wards had at least one antimicrobial ordered and were included in this study. The most commonly treated infectious diseases were tuberculosis, pneumonia, and septicemia. Treatment of drug sensitive tuberculosis is standardized in a four-drug combination pill of rifampicin, isoniazid, pyrazinamide and ethambutol, therefore appropriateness of therapy was not further evaluated. The most common antimicrobials ordered were cefotaxime (n = 45), ceftriaxone (n = 28), and metronidazole (n = 14). Overall, 67% of antimicrobial orders were inappropriately prescribed to some extent, largely driven by incorrect dose or frequency in patients with renal dysfunction. Antimicrobial prescribing among hospitalized patients at UTH is common and there is room for optimization of a majority of antimicrobial orders. Availability of certain antimicrobials must be taken into consideration during AMS program development.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85079214785&doi=10.1371%2fjournal.pone.0228555&partnerID=40&md5=dd4011cb29254abca3e4c421aaf1a2b7; http://hdl.handle.net/10713/12025
- Prescribing patterns of antimicrobials in the Internal Medicine Department of Ibrahim Malik Teaching Hospital in Khartoum, 2016.
- Authors: Abdalla SN, Yousef BA
- Issue date: 2019
- 'Careful goodbye at the door': is there role for antimicrobial stewardship interventions for antimicrobial therapy prescribed on hospital discharge?
- Authors: Chavada R, Davey J, O'Connor L, Tong D
- Issue date: 2018 May 16
- Evaluation of current practice of antimicrobial use and clinical outcome of patients with pneumonia at a tertiary care hospital in Ethiopia: A prospective observational study.
- Authors: Fenta T, Engidawork E, Amogne W, Berha AB
- Issue date: 2020
- Status of antimicrobial stewardship programmes in Nigerian tertiary healthcare facilities: Findings and implications.
- Authors: Fadare JO, Ogunleye O, Iliyasu G, Adeoti A, Schellack N, Engler D, Massele A, Godman B
- Issue date: 2019 Jun
- Outcomes of an electronic medical record (EMR)-driven intensive care unit (ICU)-antimicrobial stewardship (AMS) ward round: Assessing the "Five Moments of Antimicrobial Prescribing".
- Authors: Devchand M, Stewardson AJ, Urbancic KF, Khumra S, Mahony AA, Walker S, Garrett K, Grayson ML, Trubiano JA
- Issue date: 2019 Oct