Point prevalence survey of antibiotic use and resistance at a referral hospital in Kenya: findings and implications.

Okoth, Caleb, Opanga, Sylvia, Okalebo, Faith, Oluka, Margaret, Baker Kurdi, Amanj and Godman, Brian ORCID: 0000-0001-6539-6972 (2018) Point prevalence survey of antibiotic use and resistance at a referral hospital in Kenya: findings and implications. Hospital practice (1995), 46 (3). pp. 128-136.

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Abstract

<h4>Background and aims</h4>A substantial amount of antibiotic use in hospitals may be inappropriate, potentially leading to the development and spread of antibiotic resistance, adverse effects, mortality and increased hospital costs. The objective was to assess current patterns of antibiotic use in a leading referral hospital in Western Kenya. This would lead to the identification of opportunities for quality improvement in this hospital and others across Kenya.<h4>Methodology</h4>A point prevalence survey was carried out with data abstracted principally from patient medical records supplemented by interviews from physicians when needed. The pattern of antibiotic use was analyzed by descriptive methods. Differences in antibiotic use and indications between the selected wards were compared using the Chi-square test or Fisher's exact tests.<h4>Results</h4>Among the patients surveyed, 67.7% were on antibiotics. The most common classes of antibiotics prescribed were third generation cephalosporins (55%), imidazole derivatives like metronidazole (41.8%) and broad spectrum penicillins (41.8%). The most common indication for antibiotic use was medical prophylaxis (29%), with local guidelines advocating antibiotic prophylaxis in mothers after delivery of their child as well as in neonates with birth asphyxia and low weight at birth. Dosing of antibiotics was seen as generally optimal when assessed against current recommendations.<h4>Conclusion</h4>Whilst the dosing of antibiotics seemed adequate, there was high use of antibiotics in this hospital. This needs to be urgently reviewed with currently appreciable empiric antibiotic use. Programmes are being instigated to address these concerns. This includes developing antibiotic guidelines and formularies especially for empiric use as well as implementing antimicrobial stewardship activities.

Item Type:	Article
Uncontrolled Keywords:	Humans, Anti-Bacterial Agents, Hospitalization, Prevalence, Drug Resistance, Microbial, Drug Utilization, Kenya, Female, Male, Drug Prescriptions, Surveys and Questionnaires, Practice Patterns, Physicians'
Depositing User:	Symplectic Admin
Date Deposited:	27 Apr 2018 10:54
Last Modified:	19 Jan 2023 06:35
DOI:	10.1080/21548331.2018.1464872
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3020670