A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa
ABSTRACT: Objectives: Data on antimicrobial consumption among the paediatric population in public hospitals in South Africa are limited. This needs to be addressed to improve future antimicrobial use and reduce antimicrobial resistance rates. This study aimed to quantify antimicrobial usage and to...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221371652100271X |
| _version_ | 1811242143775195136 |
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| author | P.P. Skosana N. Schellack B. Godman A. Kurdi M. Bennie D. Kruger J.C. Meyer |
| author_facet | P.P. Skosana N. Schellack B. Godman A. Kurdi M. Bennie D. Kruger J.C. Meyer |
| author_sort | P.P. Skosana |
| collection | DOAJ |
| description | ABSTRACT: Objectives: Data on antimicrobial consumption among the paediatric population in public hospitals in South Africa are limited. This needs to be addressed to improve future antimicrobial use and reduce antimicrobial resistance rates. This study aimed to quantify antimicrobial usage and to identify and classify which antimicrobials are used in the paediatric population in public sector hospitals in South Africa according to the World Health Organization (WHO) AWaRe list of antimicrobials. Methods: A point prevalence survey was conducted among 18 public sector hospitals from nine provinces using a newly developed web-based application. Data were analysed according to the WHO AWaRe list to guide future quality improvement programmes. Results: A total of 1261 paediatric patient files were reviewed, with 49.7% (627/1261) receiving at least one antimicrobial and with 1013 antimicrobial prescriptions overall. The top five antimicrobials included ampicillin (16.4%), gentamicin (10.0%), amoxicillin/enzyme inhibitor (9.6%), ceftriaxone (7.4%) and amikacin (6.3%). Antimicrobials from the ‘Access’ classification were the most used (55.9%), with only 3.1% being from the ‘Reserve’ classification. The most common infectious conditions for which an antimicrobial was prescribed were pneumonia (14.6%; 148/1013) and clinical sepsis (11.0%; 111/1013). Parenteral administration (75.6%; 766/1013) and prolonged surgical prophylaxis (66.7%; 10/15) were common concerns. Only 28.0% (284/1013) of prescribed antimicrobials had cultures requested; of which only 38.7% (110/284) of culture results were available in the files. Conclusion: Overall, antimicrobial prescribing is common among paediatric patients in South Africa. Interventions should be targeted at improving antimicrobial prescribing, including surgical prophylaxis, and encouraging greater use of oral antibiotics. |
| first_indexed | 2024-04-12T13:46:41Z |
| format | Article |
| id | doaj.art-5e0b6b378b6a4d3ead7e444bbf842936 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-12T13:46:41Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-5e0b6b378b6a4d3ead7e444bbf8429362022-12-22T03:30:39ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-06-0129542550A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South AfricaP.P. Skosana0N. Schellack1B. Godman2A. Kurdi3M. Bennie4D. Kruger5J.C. Meyer6School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Gauteng, South Africa; Corresponding author. P.P. Skosana. Tel.: + 27 72 923 7269.Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng, South AfricaSchool of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Gauteng, South Africa; Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK; Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab EmiratesSchool of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Gauteng, South Africa; Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK; Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, IraqStrathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UKSchool of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Gauteng, South AfricaSchool of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Gauteng, South AfricaABSTRACT: Objectives: Data on antimicrobial consumption among the paediatric population in public hospitals in South Africa are limited. This needs to be addressed to improve future antimicrobial use and reduce antimicrobial resistance rates. This study aimed to quantify antimicrobial usage and to identify and classify which antimicrobials are used in the paediatric population in public sector hospitals in South Africa according to the World Health Organization (WHO) AWaRe list of antimicrobials. Methods: A point prevalence survey was conducted among 18 public sector hospitals from nine provinces using a newly developed web-based application. Data were analysed according to the WHO AWaRe list to guide future quality improvement programmes. Results: A total of 1261 paediatric patient files were reviewed, with 49.7% (627/1261) receiving at least one antimicrobial and with 1013 antimicrobial prescriptions overall. The top five antimicrobials included ampicillin (16.4%), gentamicin (10.0%), amoxicillin/enzyme inhibitor (9.6%), ceftriaxone (7.4%) and amikacin (6.3%). Antimicrobials from the ‘Access’ classification were the most used (55.9%), with only 3.1% being from the ‘Reserve’ classification. The most common infectious conditions for which an antimicrobial was prescribed were pneumonia (14.6%; 148/1013) and clinical sepsis (11.0%; 111/1013). Parenteral administration (75.6%; 766/1013) and prolonged surgical prophylaxis (66.7%; 10/15) were common concerns. Only 28.0% (284/1013) of prescribed antimicrobials had cultures requested; of which only 38.7% (110/284) of culture results were available in the files. Conclusion: Overall, antimicrobial prescribing is common among paediatric patients in South Africa. Interventions should be targeted at improving antimicrobial prescribing, including surgical prophylaxis, and encouraging greater use of oral antibiotics.http://www.sciencedirect.com/science/article/pii/S221371652100271XPaediatricAntibioticsAntimicrobial consumptionPoint prevalence surveyAWaRe list of antimicrobialsSouth Africa |
| spellingShingle | P.P. Skosana N. Schellack B. Godman A. Kurdi M. Bennie D. Kruger J.C. Meyer A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa Journal of Global Antimicrobial Resistance Paediatric Antibiotics Antimicrobial consumption Point prevalence survey AWaRe list of antimicrobials South Africa |
| title | A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa |
| title_full | A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa |
| title_fullStr | A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa |
| title_full_unstemmed | A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa |
| title_short | A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa |
| title_sort | national multicentre web based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across south africa |
| topic | Paediatric Antibiotics Antimicrobial consumption Point prevalence survey AWaRe list of antimicrobials South Africa |
| url | http://www.sciencedirect.com/science/article/pii/S221371652100271X |
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