Antimicrobial use in hospitalized patients: a point prevalence survey across four tertiary hospitals in Niger.

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-10-30 eCollection Date: 2024-10-01 DOI:10.1093/jacamr/dlae175

Ounoussa Tapha, Cyriaque Comlan Degbey, Abdourahamane Yacouba, Espère Mahouna Tchioundjro, N'Kpingou Théodore Nadakou, Ibrahim Alkassoum Salifou, Sahada Moussa Saley, Mamane Daou, Souleymane Brah, Eric Omar Adehossi, Antoine Vikkey Hinson, Saidou Mamadou

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Abstract

Background: Antimicrobial resistance (AMR) is a global threat to public health. Misuse or overuse of antimicrobials contributes to the emergence of AMR. Data on antimicrobial prescribing represent the cornerstone for guiding antimicrobial stewardship strategies. This study aimed to assess the use, indications, classification, and quality indicators of antimicrobials prescribed to patients in four tertiary hospitals in Niger.

Methods: This cross-sectional study used the methodology for Global Point Prevalence Surveys in tertiary hospitals between January and April 2024. Hospital records of all inpatients on admission at 08:00 hours on a specific day were reviewed for antimicrobial use during the survey.

Results: The overall prevalence of antibiotic use across hospitals was 54.5% (n = 470/862), ranging between 66.2% (n = 149/234) and 44.3% (n = 183/258). Most antibiotics used were antibacterials (89.0%, n = 637). Third-generation cephalosporins (48.2%, 307/637), imidazole derivatives (14.7%, 105/716), penicillins with extended spectrum (9.6%, 69/716), and fluoroquinolones (6.1%, 44/716) were the most commonly prescribed classes of antibiotics. Most antibiotics (84.9%, n = 608) were prescribed to treat community-acquired infections, while surgical prophylaxis accounted for 6.4% (n = 47/716). Most antibiotics (96.1%; n = 688/716) were used empirically, and less than a quarter (20.7%) of antibiotics prescribed had a documented stop/review date recorded. Only, 4.2% (n = 31/716) of prescribed antibiotics had cultures and susceptibility testing requested.

Conclusion: This study shows that antibiotic prescription rates are high in tertiary hospitals, with relatively high use of third-generation cephalosporins. Most antibiotics were empirically used and not guided by culture and susceptibility testing. These results could be the subject of key interventions for hospital antibiotic stewardship strategies in Niger.

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住院病人的抗菌药使用情况：尼日尔四家三级医院的点流行率调查。

背景：抗菌药耐药性（AMR）是对公共卫生的全球性威胁。滥用或过度使用抗菌药物会导致 AMR 的出现。抗菌药物处方数据是指导抗菌药物管理策略的基石。本研究旨在评估尼日尔四家三级医院为患者开具的抗菌药物的使用、适应症、分类和质量指标：这项横断面研究采用了 2024 年 1 月至 4 月期间在三级医院进行的全球点流行率调查的方法。在调查期间，对特定日期 8:00 时入院的所有住院病人的医院记录进行了审查，以了解抗菌药物的使用情况：各医院使用抗生素的总体比例为 54.5%（n = 470/862），介于 66.2%（n = 149/234）和 44.3%（n = 183/258）之间。大多数抗生素为抗菌药（89.0%，n = 637）。第三代头孢菌素（48.2%，307/637）、咪唑类衍生物（14.7%，105/716）、广谱青霉素类（9.6%，69/716）和氟喹诺酮类（6.1%，44/716）是最常用的抗生素类别。大多数抗生素（84.9%，n = 608）用于治疗社区获得性感染，而手术预防占 6.4%（n = 47/716）。大多数抗生素（96.1%；n = 688/716）都是根据经验使用的，只有不到四分之一（20.7%）的抗生素处方记录了停药/复查日期。只有 4.2% 的处方抗生素（n = 31/716）要求进行培养和药敏试验：本研究表明，三级医院的抗生素处方率较高，其中第三代头孢菌素的使用率相对较高。大多数抗生素都是经验性使用，而不是以培养和药敏试验为指导。这些结果可能成为尼日尔医院抗生素管理战略的关键干预措施。

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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