评估肯尼亚一家县转诊医院住院患者抗生素处方模式的点流行率调查

M. Kamita, Michael Maina, R. Kimani, R. Mwangi, D. Mureithi, Cynthia Nduta, J. Gitaka
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引用次数: 2

摘要

抗生素耐药性会导致更高的发病率和死亡率以及更高的医疗费用。影响抗生素耐药性出现的因素之一是抗生素的不当使用。临床从业者不正确的处方模式和无视抗生素使用建议是导致这种耐药性的主要原因。这项研究调查了Kiambu五级医院(KL5)住院患者的抗生素处方模式,以寻找改善医院质量的潜力。这项研究于2021年7月进行,研究当天住院的所有患者都包括在内。该信息是使用世界卫生组织点流行率调查(PPS)仪器从患者医疗记录中提取的。收集并输入匿名数据,然后使用SPSS 26版进行分析。在308名接受调查的患者中,191名(62%)接受了抗生素治疗,其中60.1%为女性。儿科病房的抗生素处方率为94.1%,抗生素使用率最高,其次是内科病房(69.2%)和妇科病房(65.6%)。超过40%的抗生素处方具有预防性医学指征。青霉素G是社区获得性感染最常用的抗生素(32.2%),其次是第三代头孢菌素(27.6%)和氨基糖苷类抗生素(17.2%)。根据AWaRe分类,57%的处方抗生素属于Access类,42%属于Watch类。不完整的适应症部位、缺乏给药方法和给药时间是医疗记录中缺失的一些符合性。这项研究表明,抗生素处方率很高,尤其是对年轻患者,滥用抗生素的风险更高。这些数据为在肯尼亚医院使用抗生素管理做法提供了令人信服的理由。
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Point prevalence survey to assess antibiotic prescribing pattern among hospitalized patients in a county referral hospital in Kenya
Antibiotic resistance causes higher morbidity and mortality and higher healthcare costs. One of the factors influencing the emergence of antibiotic resistance is the inappropriate use of antibiotics. Clinical practitioners’ incorrect prescription patterns and a disregard for antibiotic usage recommendations are the leading causes of this resistance. This study examined the antibiotic prescription patterns among hospitalized patients at the Kiambu Level 5 hospital (KL5) to find potential for hospital quality improvement. This study was conducted in July 2021, and all patients hospitalized on the study day were included. The information was extracted from patient medical records using a World Health Organization Point Prevalence Survey (PPS) instrument. Anonymized data was gathered, entered, and then SPSS version 26 was used for analysis. Among the 308 surveyed patients, 191 (62%) received antibiotic medication, and 60.1% of the total were female. The pediatric ward, which had an antibiotic prescription rate of 94.1%, had the highest rate of antibiotic usage, followed by the medical ward (69.2%) and gynecological ward (65.6%). Over 40% of antibiotic prescriptions had a prophylactic medical indication. Penicillin G was the most prescribed antibiotic for community-acquired infections (32.2%), followed by 3rd generation cephalosporins (27.6%) and aminoglycosides (17.2%). Based on the AWaRe classification, 57% of the prescribed antibiotics were in the Access class while 42% were in the Watch class. Incomplete site of indication, lack of a method of administration, and length of administration are some of the conformities that were missing in the medical records. This study shows that antibiotic prescription rates are high, particularly for young patients, and there is a higher risk of antibiotic misuse. The data makes a compelling justification for using antibiotic stewardship practices in Kenyan hospitals.
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