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

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-10-24 eCollection Date: 2024-10-01 DOI:10.1093/jacamr/dlae170

Joseph Yamweka Chizimu, Steward Mudenda, Kaunda Yamba, Chileshe Lukwesa, Raphael Chanda, Ruth Nakazwe, Misheck Shawa, Herman Chambaro, Harvey K Kamboyi, Aubrey Chichonyi Kalungia, Duncan Chanda, Sombo Fwoloshi, Elimas Jere, Tiza Mufune, Derick Munkombwe, Peter Lisulo, Tebuho Mateele, Jeewan Thapa, Kenneth Kapolowe, Nyambe Sinyange, Cephas Sialubanje, Nathan Kapata, Mirfin Mpundu, Freddie Masaninga, Khalid Azam, Chie Nakajima, Makomani Siyanga, Nathan Nsubuga Bakyaita, Evelyn Wesangula, Martin Matu, Yasuhiko Suzuki, Roma Chilengi

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Abstract

Background: 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: 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: 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: 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.

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赞比亚 16 家医院的抗生素使用情况和对世界卫生组织 AWaRe 指南的遵守情况：点流行率调查。

背景：医院抗生素的不当使用会导致抗菌药耐药性（AMR）的产生和传播。本研究评估了赞比亚16家医院的抗生素使用率以及是否遵守世界卫生组织（WHO）的抗生素使用、观察和储备（AWaRe）分类：2023 年 12 月，采用世界卫生组织点流行率调查 (PPS) 方法和世界卫生组织 AWaRe 抗生素分类，对赞比亚 16 家医院的住院病人进行了一项描述性横断面研究。数据分析采用 STATA 17.0 版：在接受调查的 16 家医院的 1296 名住院患者中，56% 为女性，54% 年龄在 16 岁至 50 岁之间。使用抗生素的总体比例为 70%。此外，52%的住院患者使用了观察组抗生素，其中头孢曲松是处方量最大的抗生素。略低于一半（48%）的住院患者使用了Access组抗生素。遵守当地治疗指南的比例为 53%：这项研究发现，在赞比亚接受调查的医院中，住院病人处方和使用抗生素的比例很高。观察组抗生素的高使用率超过了建议的阈值，表明没有遵守世界卫生组织的 AWaRe 抗生素使用指南。因此，有必要建立并加强抗菌药物管理计划，促进赞比亚医院合理使用抗生素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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