肯尼亚Kirinyaga县医院抗生素使用的点流行调查和模式

Perpetua Wanjiku Karanja, Anthony Kiunga
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引用次数: 1

摘要

背景:抗生素在治疗和管理门诊和住院的感染方面是有用的。然而,不合理的抗生素使用可导致患者护理不当、抗微生物药物耐药性、资源浪费,有时甚至导致死亡。抗生素的使用模式因医生、感染、病人、病房、国家和地区而异。这项研究是作为基线进行的,以描述基里尼亚加县医院抗生素使用的流行程度和模式。方法学:该研究是对Kirinyaga县四家医院收治的患者抗生素使用情况的点流行病学调查,研究采用了世界卫生组织医院抗生素使用情况点流行病学调查方法。数据是从使用预测试工具同意的患者档案中提取的。结果:Kirinyaga县4家医院抗生素使用率为44.0% (95%CI 38.6 ~ 49.5%)。青霉素是处方最多的抗生素类别,占29.1%,其次是头孢菌素,占23.0%。头孢曲松和甲硝唑的处方率最高,分别为22.0%和19.8%。抗生素主要用于社区获得性感染,占58.2%,其次是手术预防,占26.0%。大多数患者(52.5%)使用两种抗生素,主要是青霉素和庆大霉素,占40.3%。所有抗生素中,大多数(63.0%)是通过肠外给药。治疗单上的用药记录很差。结论:该院抗菌药物使用率较高,均为经验性处方。社区获得性感染是最常见的抗生素适应症。存在大量使用世界卫生组织“监视”类抗生素而不进行微生物试验的情况。有必要制定抗生素管理计划,以确保抗生素的司法使用。
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Point Prevalence Survey and Patterns of Antibiotic Use at Kirinyaga County Hospitals, Kenya
Background: Antibiotics are useful in treating and managing infections in outpatient and inpatient care settings. However, irrational antibiotic use can lead to improper patient care, antimicrobial resistance, wastage of resources and sometimes even death. The pattern of antibiotic use varies from one medical practitioner to another, infection, patient, wards, country and region. The study was a conducted as a baseline to describe the prevalence and patterns of antibiotic use in Kirinyaga County hospitals. Methodology: The study was a point prevalence survey of antibiotics use among patients admitted to four hospitals in Kirinyaga county and the study utilised the World Health Organization methodology for point prevalence survey of antibiotics in hospitals. Data were abstracted from patients’ files of patients who consented using a pretested tool. The data was exported to MS Excel for cleaning and analysed descriptively Results: The prevalence of antibiotic use in the four hospitals in Kirinyaga county was 44.0% (95%CI 38.6-49.5%). Penicillins were the most prescribed antibiotic class at 29.1%, followed by cephalosporins at 23.0%. Ceftriaxone and metronidazole were the highest prescribed at 22.0% and 19.8%, respectively. Antibiotics were mainly prescribed for community-acquired infections at 58.2%, followed by surgical prophylaxis at 26.0%. Most patients (52.5%) received two antibiotics, predominantly benzylpenicillin and gentamicin, at 40.3%. The majority, 63.0%, of all antibiotics were administered parenterally. There was poor documentation of the administration of medicines on the treatment sheet. Conclusion: There was a relatively high prevalence of antibiotic use, all prescribed empirically. Community acquired infections were the most common indication for antibiotics. There was extensive use World Health Organization “watch” category of antibiotics without microbiological tests. There is a need for antibiotic stewardship program to ensure judicial use of antibiotics.
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