Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report
Abstract Background Although one of the main drivers of antimicrobial resistance is inappropriate antibiotic prescribing, there are limited resources to support the surveillance of antibiotic consumption in low-income countries. In this study, we aimed to assess antibiotic use and consumption among...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08517-0 |
| _version_ | 1827781204363968512 |
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| author | Sulaiman Lakoh Christine Ellen Elleanor Williams Stephen Sevalie James B.W. Russell Sarah K. Conteh Joseph Sam Kanu Umu Barrie Gibrilla F. Deen Anna Maruta Daniel Sesay Olukemi Adekanmbi Darlinda F. Jiba Joseph Chukwudi Okeibunor George A. Yendewa Emmanuel Firima |
| author_facet | Sulaiman Lakoh Christine Ellen Elleanor Williams Stephen Sevalie James B.W. Russell Sarah K. Conteh Joseph Sam Kanu Umu Barrie Gibrilla F. Deen Anna Maruta Daniel Sesay Olukemi Adekanmbi Darlinda F. Jiba Joseph Chukwudi Okeibunor George A. Yendewa Emmanuel Firima |
| author_sort | Sulaiman Lakoh |
| collection | DOAJ |
| description | Abstract Background Although one of the main drivers of antimicrobial resistance is inappropriate antibiotic prescribing, there are limited resources to support the surveillance of antibiotic consumption in low-income countries. In this study, we aimed to assess antibiotic use and consumption among medical patients of two hospitals in different geographic regions of Sierra Leone. Methods This is a cross-sectional study of adult (18 years or older) patients receiving medical care at two hospitals (34 Military Hospital-MH and Makeni Government Hospital-MGH) between March 2021 and October 2021. After admission to the medical or intensive care unit, patients were sequentially recruited by a nurse from each hospital. Demographic and clinical characteristics and information on the dose of antibiotics, their routes, and frequency of administration and duration were collected using a questionnaire adapted from previous studies and encrypted in EpiCollect software (Epic, Verona WI). A physician reviews and verifies each completed questionnaire. Data analysis was done using STATA version 16. Results The mean age of the 468 patients evaluated in this study was 48.6 years. The majority were women (241, 51.7%) and treated at MGH (245, 52.0%). Clinical diagnosis of bacterial infection was made in only 180 (38.5%) patients. Regardless of the diagnosis, most (442, 94.9%) patients received at least one antibiotic. Of a total 813 doses of antibiotics prescribed by the two hospitals, 424 (52.2%) were administered in MH. Overall, antibiotic consumption was 66.9 defined daily doses (DDDs) per 100 bed-days, with ceftriaxone being the most commonly used antibiotic (277, 34.1%). The ACCESS and WATCH antibiotics accounted for 18.9 DDDs per 100 bed-days (28.2%) and 48.0 DDDs per 100 bed-days (71.7%), respectively. None of the patients were prescribed a RESERVE antibiotics. The antibiotic consumption was lower in MH (61.3 DDDs per 100 bed-days) than MGH (76.5 DDDs per 100 bed-days). Conclusion Antibiotic consumption was highest with ceftriaxone, followed by levofloxacin and metronidazole. Given the high rate of consumption of antibiotics in the WATCH category of the AWaRe classification, there is a need to initiate surveillance of antibiotic consumption and establish hospital-based antibiotic stewardship in these settings. |
| first_indexed | 2024-03-11T15:15:37Z |
| format | Article |
| id | doaj.art-3633f2a4a0734518b7f7ce92b96f0ce7 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-11T15:15:37Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-3633f2a4a0734518b7f7ce92b96f0ce72023-10-29T12:16:05ZengBMCBMC Infectious Diseases1471-23342023-10-012311810.1186/s12879-023-08517-0Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive reportSulaiman Lakoh0Christine Ellen Elleanor Williams1Stephen Sevalie2James B.W. Russell3Sarah K. Conteh4Joseph Sam Kanu5Umu Barrie6Gibrilla F. Deen7Anna Maruta8Daniel Sesay9Olukemi Adekanmbi10Darlinda F. Jiba11Joseph Chukwudi Okeibunor12George A. Yendewa13Emmanuel Firima14College of Medicine and Allied Health Sciences, University of Sierra LeoneCollege of Medicine and Allied Health Sciences, University of Sierra LeoneCollege of Medicine and Allied Health Sciences, University of Sierra LeoneCollege of Medicine and Allied Health Sciences, University of Sierra LeoneMinistry of Health and Sanitation, Government of Sierra LeoneCollege of Medicine and Allied Health Sciences, University of Sierra LeoneInfectious Disease Research NetworkCollege of Medicine and Allied Health Sciences, University of Sierra LeoneWorld Health Organization Country OfficeMinistry of Health and Sanitation, Government of Sierra LeoneDepartment of Medicine, College of Medicine, University of IbadanMinistry of Health and Sanitation, Government of Sierra LeoneWorld Health Organization Regional Office for AfricaDepartment of Medicine, Case Western Reserve University School of MedicineDepartment of Medicine, Clinical Research Unit, Swiss Tropical and Public Health InstituteAbstract Background Although one of the main drivers of antimicrobial resistance is inappropriate antibiotic prescribing, there are limited resources to support the surveillance of antibiotic consumption in low-income countries. In this study, we aimed to assess antibiotic use and consumption among medical patients of two hospitals in different geographic regions of Sierra Leone. Methods This is a cross-sectional study of adult (18 years or older) patients receiving medical care at two hospitals (34 Military Hospital-MH and Makeni Government Hospital-MGH) between March 2021 and October 2021. After admission to the medical or intensive care unit, patients were sequentially recruited by a nurse from each hospital. Demographic and clinical characteristics and information on the dose of antibiotics, their routes, and frequency of administration and duration were collected using a questionnaire adapted from previous studies and encrypted in EpiCollect software (Epic, Verona WI). A physician reviews and verifies each completed questionnaire. Data analysis was done using STATA version 16. Results The mean age of the 468 patients evaluated in this study was 48.6 years. The majority were women (241, 51.7%) and treated at MGH (245, 52.0%). Clinical diagnosis of bacterial infection was made in only 180 (38.5%) patients. Regardless of the diagnosis, most (442, 94.9%) patients received at least one antibiotic. Of a total 813 doses of antibiotics prescribed by the two hospitals, 424 (52.2%) were administered in MH. Overall, antibiotic consumption was 66.9 defined daily doses (DDDs) per 100 bed-days, with ceftriaxone being the most commonly used antibiotic (277, 34.1%). The ACCESS and WATCH antibiotics accounted for 18.9 DDDs per 100 bed-days (28.2%) and 48.0 DDDs per 100 bed-days (71.7%), respectively. None of the patients were prescribed a RESERVE antibiotics. The antibiotic consumption was lower in MH (61.3 DDDs per 100 bed-days) than MGH (76.5 DDDs per 100 bed-days). Conclusion Antibiotic consumption was highest with ceftriaxone, followed by levofloxacin and metronidazole. Given the high rate of consumption of antibiotics in the WATCH category of the AWaRe classification, there is a need to initiate surveillance of antibiotic consumption and establish hospital-based antibiotic stewardship in these settings.https://doi.org/10.1186/s12879-023-08517-0Defined daily dose (DDD)ACCESS, WATCH and RESERVE (AWaRe)Antibiotic consumptionSierra LeoneAntimicrobial resistance (AMR) |
| spellingShingle | Sulaiman Lakoh Christine Ellen Elleanor Williams Stephen Sevalie James B.W. Russell Sarah K. Conteh Joseph Sam Kanu Umu Barrie Gibrilla F. Deen Anna Maruta Daniel Sesay Olukemi Adekanmbi Darlinda F. Jiba Joseph Chukwudi Okeibunor George A. Yendewa Emmanuel Firima Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report BMC Infectious Diseases Defined daily dose (DDD) ACCESS, WATCH and RESERVE (AWaRe) Antibiotic consumption Sierra Leone Antimicrobial resistance (AMR) |
| title | Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report |
| title_full | Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report |
| title_fullStr | Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report |
| title_full_unstemmed | Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report |
| title_short | Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report |
| title_sort | antibiotic use and consumption among medical patients of two hospitals in sierra leone a descriptive report |
| topic | Defined daily dose (DDD) ACCESS, WATCH and RESERVE (AWaRe) Antibiotic consumption Sierra Leone Antimicrobial resistance (AMR) |
| url | https://doi.org/10.1186/s12879-023-08517-0 |
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