Antibiotic Prescribing Patterns at a Leading Referral Hospital in Kenya: A Point Prevalence Survey.
Antibiotics
Kenya
point prevalence survey
prescribing
utilization
Journal
Journal of research in pharmacy practice
ISSN: 2319-9644
Titre abrégé: J Res Pharm Pract
Pays: India
ID NLM: 101614023
Informations de publication
Date de publication:
Historique:
received:
28
08
2018
accepted:
27
01
2019
entrez:
16
11
2019
pubmed:
16
11
2019
medline:
16
11
2019
Statut:
epublish
Résumé
Antibiotics are essential with inappropriate use leading to antimicrobial resistance (AMR). Currently, little is known about antibiotic use among hospitals in Kenya, which is essential to tackle as part of the recent national action plan addressing rising AMR rates. Consequently, the objective was to overcome this gap in a leading referral hospital in Kenya. The findings will subsequently be used to develop quality improvement programs for this and other hospitals in Kenya. This was a point prevalence survey. Data on antibiotic use were abstracted from patient medical records by a pharmacy team. The prevalence of antibiotic prescribing was 54.7%, highest in the intensive care unit and isolation wards. Most antibiotics were for treatment (75.4%) rather than prophylaxis (29.0%). The majority of patients on surgical prophylaxis were on prolonged duration (>1 day), with only 9.6% on a single dose as per current guidelines. Penicillins (46.9%) followed by cephalosporins (44.7%) were the most prescribed antibiotic classes. The indication for antibiotic use was documented in only 37.3% of encounters. Generic prescribing was 62.5% and empiric prescribing was seen in 82.6% of encounters. Guideline compliance was 45.8%. Several areas for improvement were identified including addressing prolonged duration for prophylaxis, extensive prescribing of broad-spectrum antibiotics, high rates of empiric prescribing, and lack of documenting the indication for antimicrobials. Initiatives are ongoing to address this with pharmacists playing a key role.
Identifiants
pubmed: 31728346
doi: 10.4103/jrpp.JRPP_18_68
pii: JRPP-8-149
pmc: PMC6830017
doi:
Types de publication
Journal Article
Langues
eng
Pagination
149-154Informations de copyright
Copyright: © 2019 Journal of Research in Pharmacy Practice.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Clin Infect Dis. 2004 Jun 15;38(12):1706-15
pubmed: 15227616
J Hosp Infect. 2019 Jan;101(1):60-68
pubmed: 29730140
Indian J Pediatr. 2012 Nov;79(11):1482-8
pubmed: 22562262
J Hosp Infect. 2013 Dec;85(4):257-67
pubmed: 24209885
Expert Rev Anti Infect Ther. 2018 May;16(5):381-384
pubmed: 29672172
Hosp Pract (1995). 2018 Aug;46(3):97-102
pubmed: 29521136
PLoS One. 2013 Nov 11;8(11):e78942
pubmed: 24244390
Bull World Health Organ. 2016 Aug 1;94(8):558-558A
pubmed: 27516629
Hosp Pract (1995). 2018 Aug;46(3):128-136
pubmed: 29652559
Antibiotics (Basel). 2014 Sep 10;3(3):450-60
pubmed: 27025755
Pediatr Infect Dis J. 2019 Feb;38(2):122-126
pubmed: 29677085
Lancet. 2016 Jan 9;387(10014):168-75
pubmed: 26603918
Lancet Glob Health. 2018 Jun;6(6):e619-e629
pubmed: 29681513
J Antimicrob Chemother. 2016 Jun;71(6):1697-706
pubmed: 26945712