Antibiotic use and adherence to the WHO AWaRe guidelines across 16 hospitals in Zambia: a point prevalence survey.


Journal

JAC-antimicrobial resistance
ISSN: 2632-1823
Titre abrégé: JAC Antimicrob Resist
Pays: England
ID NLM: 101765283

Informations de publication

Date de publication:
Oct 2024
Historique:
received: 24 07 2024
accepted: 30 09 2024
medline: 28 10 2024
pubmed: 28 10 2024
entrez: 28 10 2024
Statut: epublish

Résumé

The inappropriate use of antibiotics in hospitals contributes to the development and spread of antimicrobial resistance (AMR). This study evaluated the prevalence of antibiotic use and adherence to the World Health Organization (WHO) Access, Watch and Reserve (AWaRe) classification of antibiotics across 16 hospitals in Zambia. A descriptive, cross-sectional study employing the WHO Point Prevalence Survey (PPS) methodology and WHO AWaRe classification of antibiotics was conducted among inpatients across 16 hospitals in December 2023, Zambia. Data analysis was performed using STATA version 17.0. Of the 1296 inpatients surveyed in the 16 hospitals, 56% were female, and 54% were aged between 16 and 50 years. The overall prevalence of antibiotic use was 70%. Additionally, 52% of the inpatients received Watch group antibiotics, with ceftriaxone being the most prescribed antibiotic. Slightly below half (48%) of the inpatients received Access group antibiotics. Compliance with the local treatment guidelines was 53%. This study found a high prevalence of prescribing and use of antibiotics in hospitalized patients across the surveyed hospitals in Zambia. The high use of Watch group antibiotics was above the recommended threshold indicating non-adherence to the WHO AWaRe guidelines for antibiotic use. Hence, there is a need to establish and strengthen antimicrobial stewardship programmes that promote the rational use of antibiotics in hospitals in Zambia.

Sections du résumé

Background UNASSIGNED
The inappropriate use of antibiotics in hospitals contributes to the development and spread of antimicrobial resistance (AMR). This study evaluated the prevalence of antibiotic use and adherence to the World Health Organization (WHO) Access, Watch and Reserve (AWaRe) classification of antibiotics across 16 hospitals in Zambia.
Methods UNASSIGNED
A descriptive, cross-sectional study employing the WHO Point Prevalence Survey (PPS) methodology and WHO AWaRe classification of antibiotics was conducted among inpatients across 16 hospitals in December 2023, Zambia. Data analysis was performed using STATA version 17.0.
Results UNASSIGNED
Of the 1296 inpatients surveyed in the 16 hospitals, 56% were female, and 54% were aged between 16 and 50 years. The overall prevalence of antibiotic use was 70%. Additionally, 52% of the inpatients received Watch group antibiotics, with ceftriaxone being the most prescribed antibiotic. Slightly below half (48%) of the inpatients received Access group antibiotics. Compliance with the local treatment guidelines was 53%.
Conclusions UNASSIGNED
This study found a high prevalence of prescribing and use of antibiotics in hospitalized patients across the surveyed hospitals in Zambia. The high use of Watch group antibiotics was above the recommended threshold indicating non-adherence to the WHO AWaRe guidelines for antibiotic use. Hence, there is a need to establish and strengthen antimicrobial stewardship programmes that promote the rational use of antibiotics in hospitals in Zambia.

Identifiants

pubmed: 39464860
doi: 10.1093/jacamr/dlae170
pii: dlae170
pmc: PMC11503655
doi:

Types de publication

Journal Article

Langues

eng

Pagination

dlae170

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

Auteurs

Joseph Yamweka Chizimu (JY)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia.
Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.

Steward Mudenda (S)

Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Kaunda Yamba (K)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia.
Action against Antimicrobial Resistance (ReAct) Africa, Lusaka, Zambia.

Chileshe Lukwesa (C)

Department of Health, Lusaka District Health Office, Lusaka, Zambia.

Raphael Chanda (R)

Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia.

Ruth Nakazwe (R)

Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia.

Misheck Shawa (M)

Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.

Herman Chambaro (H)

Virology Unit, Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia.

Harvey K Kamboyi (HK)

Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan.

Aubrey Chichonyi Kalungia (AC)

Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Duncan Chanda (D)

Department of Infectious Diseases, University Teaching Hospitals, Lusaka, Zambia.

Sombo Fwoloshi (S)

Department of Infectious Diseases, University Teaching Hospitals, Lusaka, Zambia.

Elimas Jere (E)

Department of Post Marketing Surveillance, Zambia Medicines Regulatory Authority, Lusaka, Zambia.

Tiza Mufune (T)

Virology Unit, Central Veterinary Research Institute, Ministry of Health, Kabwe District Health Office, Kabwe, Zambia.

Derick Munkombwe (D)

Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Peter Lisulo (P)

Department of Health, World Health Organization, Lusaka, Zambia.

Tebuho Mateele (T)

Department of Internal Medicine, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia.

Jeewan Thapa (J)

Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.

Kenneth Kapolowe (K)

Department of Internal Medicine, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia.

Nyambe Sinyange (N)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia.

Cephas Sialubanje (C)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia.

Nathan Kapata (N)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia.

Mirfin Mpundu (M)

Action against Antimicrobial Resistance (ReAct) Africa, Lusaka, Zambia.

Freddie Masaninga (F)

Department of Health, World Health Organization, Lusaka, Zambia.

Khalid Azam (K)

Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania.

Chie Nakajima (C)

Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.

Makomani Siyanga (M)

Department of Post Marketing Surveillance, Zambia Medicines Regulatory Authority, Lusaka, Zambia.

Nathan Nsubuga Bakyaita (NN)

Department of Health, World Health Organization, Lusaka, Zambia.

Evelyn Wesangula (E)

Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania.

Martin Matu (M)

Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania.

Yasuhiko Suzuki (Y)

Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Kita 20 Nishi 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.

Roma Chilengi (R)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute (ZNPHI), Lusaka, Zambia.

Classifications MeSH