Audit of antibiotic utilization patterns and practice for common eye infections at the ambulatory clinic of a teaching hospital in Ghana: Findings and implications.
Humans
Ghana
/ epidemiology
Female
Anti-Bacterial Agents
/ therapeutic use
Male
Adult
Middle Aged
Hospitals, Teaching
/ statistics & numerical data
Aged
Cross-Sectional Studies
Ambulatory Care Facilities
/ statistics & numerical data
Practice Patterns, Physicians'
/ statistics & numerical data
Eye Infections
/ drug therapy
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2024
2024
Historique:
received:
28
06
2024
accepted:
16
10
2024
medline:
29
10
2024
pubmed:
29
10
2024
entrez:
29
10
2024
Statut:
epublish
Résumé
Antimicrobial resistance (AMR) is a serious public health issue which is exacerbated by increased inappropriate use of antibiotics for common eye infections. This cross sectional survey was to assess the appropriate use of antibiotics for eye infections in an ambulatory clinic in Ghana and possible determinants. The medical records of all patients who sought eye care between January 2022 to December 2022 and were prescribed antibiotics were extracted from the hospital's electronic database. Descriptive, bivariate and multivariate analyses were then conducted. A total of 1925 patient medical records were extracted, whose median age was 40 years (IQR 26-69), and were mostly females (58.91%, n = 1134/1925). The eye condition commonly treated with antibiotics was bacteria conjunctivitis (33.51%, n = 645/1925). The most prescribed antibiotic was gentamycin (22.96%, n = 442/1925) followed by ciprofloxacin (16.78%, n = 321/1925). These were mostly topical dosage forms (82.13%, n = 1581/1925). Systemic antibiotics prescribed were mostly from the WHO 'Access' class (83.33%, n = 280/338). The appropriate choice of antibiotic prescribed was 42.44% (n = 817/1925) and this was positivity associated with age (p<0.001), number of antibiotics prescribed (p <0.001), the prescription of topical dosage forms (p <0.001), and WHO 'Access' antibiotic class (p <0.034). The level of appropriateness of antibiotic prescriptions for eye infections was sub-optimal. Antimicrobial stewardship programs, including prescriber education on guidelines and prescription audit to address associated factors, must now be instigated in this hospital to improve future antibiotic use and prevent the rise of AMR.
Sections du résumé
BACKGROUND
BACKGROUND
Antimicrobial resistance (AMR) is a serious public health issue which is exacerbated by increased inappropriate use of antibiotics for common eye infections. This cross sectional survey was to assess the appropriate use of antibiotics for eye infections in an ambulatory clinic in Ghana and possible determinants.
METHOD
METHODS
The medical records of all patients who sought eye care between January 2022 to December 2022 and were prescribed antibiotics were extracted from the hospital's electronic database. Descriptive, bivariate and multivariate analyses were then conducted.
RESULTS
RESULTS
A total of 1925 patient medical records were extracted, whose median age was 40 years (IQR 26-69), and were mostly females (58.91%, n = 1134/1925). The eye condition commonly treated with antibiotics was bacteria conjunctivitis (33.51%, n = 645/1925). The most prescribed antibiotic was gentamycin (22.96%, n = 442/1925) followed by ciprofloxacin (16.78%, n = 321/1925). These were mostly topical dosage forms (82.13%, n = 1581/1925). Systemic antibiotics prescribed were mostly from the WHO 'Access' class (83.33%, n = 280/338). The appropriate choice of antibiotic prescribed was 42.44% (n = 817/1925) and this was positivity associated with age (p<0.001), number of antibiotics prescribed (p <0.001), the prescription of topical dosage forms (p <0.001), and WHO 'Access' antibiotic class (p <0.034).
CONCLUSION
CONCLUSIONS
The level of appropriateness of antibiotic prescriptions for eye infections was sub-optimal. Antimicrobial stewardship programs, including prescriber education on guidelines and prescription audit to address associated factors, must now be instigated in this hospital to improve future antibiotic use and prevent the rise of AMR.
Identifiants
pubmed: 39471183
doi: 10.1371/journal.pone.0313019
pii: PONE-D-24-26286
pmc: PMC11521307
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0313019Informations de copyright
Copyright: © 2024 Sefah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Lancet Glob Health. 2021 Feb;9(2):e130-e143
pubmed: 33275950
Antibiotics (Basel). 2022 Feb 06;11(2):
pubmed: 35203807
Rom J Ophthalmol. 2020 Jul-Sep;64(3):245-260
pubmed: 33367158
Eye (Lond). 2021 Apr;35(4):1084-1101
pubmed: 33414529
One Health Outlook. 2021 Oct 19;3(1):18
pubmed: 34663477
J Ocul Pharmacol Ther. 2023 Mar;39(2):89-101
pubmed: 36796014
Int J Environ Res Public Health. 2022 Sep 17;19(18):
pubmed: 36141996
Sci Rep. 2022 Jun 17;12(1):10264
pubmed: 35715500
Clin Ophthalmol. 2020 Jan 29;14:287-297
pubmed: 32099313
Antibiotics (Basel). 2021 Feb 18;10(2):
pubmed: 33670731
Antibiotics (Basel). 2022 Jul 08;11(7):
pubmed: 35884175
Antibiotics (Basel). 2022 May 03;11(5):
pubmed: 35625257
J Ophthalmol. 2015;2015:813979
pubmed: 26576294
JAMA Ophthalmol. 2015 Jan;133(1):25-31
pubmed: 25232930
JAC Antimicrob Resist. 2021 Jun 14;3(2):dlab080
pubmed: 34223139
Crit Rev Food Sci Nutr. 2017 Sep 2;57(13):2857-2876
pubmed: 26464037
Expert Opin Drug Saf. 2022 Aug;21(8):1089-1111
pubmed: 35876080
Trop Med Health. 2023 Mar 9;51(1):15
pubmed: 36895063
Lancet Glob Health. 2021 Apr;9(4):e489-e551
pubmed: 33607016
Lancet Infect Dis. 2021 Jan;21(1):107-115
pubmed: 32717205
Eye Contact Lens. 2020 Sep;46(5):265-268
pubmed: 31373904
Ophthalmol Eye Dis. 2011 Oct 24;3:29-43
pubmed: 23861622
Healthcare (Basel). 2023 Jul 05;11(13):
pubmed: 37444780
Lancet. 2022 Feb 12;399(10325):629-655
pubmed: 35065702
Expert Opin Pharmacother. 2013 Aug;14(11):1449-65
pubmed: 23822862
Lancet Infect Dis. 2013 Dec;13(12):1006-7
pubmed: 24252479
Br J Biomed Sci. 2023 Jun 28;80:11387
pubmed: 37448857
Lancet Glob Health. 2013 Dec;1(6):e339-49
pubmed: 25104599
Microorganisms. 2024 Mar 25;12(4):
pubmed: 38674593
Antimicrob Resist Infect Control. 2019 Feb 12;8:35
pubmed: 30805182
Lancet Infect Dis. 2019 Dec;19(12):1278-1280
pubmed: 31782385
S Afr Med J. 2022 Oct 05;112(10):812-818
pubmed: 36472332
Lancet Infect Dis. 2022 Nov;22(11):1528-1530
pubmed: 36309019
Pan Afr Med J. 2017 Nov 07;28:214
pubmed: 29610652
BMC Infect Dis. 2017 Sep 11;17(1):616
pubmed: 28893183
J Clin Diagn Res. 2014 Jan;8(1):23-5
pubmed: 24596715
BMC Public Health. 2017 Nov 23;17(1):896
pubmed: 29169340
J Ophthalmol. 2012;2012:831502
pubmed: 22991650
Health Policy Plan. 2016 Mar;31(2):250-8
pubmed: 26045328
Prog Retin Eye Res. 2022 Jul;89:101031
pubmed: 34915112
Clin Exp Optom. 2021 Apr;104(3):295-307
pubmed: 32924208
J Am Pharm Assoc (2003). 2020 Nov - Dec;60(6):e246-e251
pubmed: 32861616
BMJ Open Ophthalmol. 2017 Aug;2:
pubmed: 29226254
Aust Prescr. 2018 Jun;41(3):67-72
pubmed: 29922000
Antimicrob Steward Healthc Epidemiol. 2024 Apr 16;4(1):e46
pubmed: 38628373
JAC Antimicrob Resist. 2022 Jul 05;4(4):dlac079
pubmed: 35795243
Clin Microbiol Infect. 2024 Jul;30(7):848-849
pubmed: 38583520
Int Ophthalmol. 2023 Oct;43(10):3717-3724
pubmed: 37395904
Clin Microbiol Infect. 2022 Dec;28(12):1533-1535
pubmed: 36007869
Int J Environ Res Public Health. 2022 Sep 29;19(19):
pubmed: 36231716
J Antimicrob Chemother. 2021 May 12;76(6):1614-1624
pubmed: 33822971
EClinicalMedicine. 2022 Mar 22;46:101354
pubmed: 35340626
JAMA Intern Med. 2023 Mar 1;183(3):213-220
pubmed: 36745412
Infect Drug Resist. 2022 Mar 03;15:765-779
pubmed: 35264860
JAMA. 2022 Jun 14;327(22):2231-2237
pubmed: 35699701
Indian J Ophthalmol. 2022 May;70(5):1513-1521
pubmed: 35502016
J Ophthalmic Vis Res. 2020 Aug 06;15(3):372-395
pubmed: 32864068
Pan Afr Med J. 2013;14:1
pubmed: 23503692
J Ophthalmic Inflamm Infect. 2021 Mar 1;11(1):7
pubmed: 33644821
BMC Ophthalmol. 2017 Nov 25;17(1):212
pubmed: 29178851