Evaluating antimicrobial prescribing in a Tertiary Healthcare Institution in Nigeria (original) (raw)
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An assessment of antimicrobial prescribing at a tertiary hospital in north-western Nigeria
2016
Background: Inappropriate antibiotic use is a public health problem worldwide. Misuse of these agents is one of the drivers of antimicrobial resistance (AMR), which is believed to be the next pandemic. Consequently, auditing antimicrobial prescription patterns can provide useful information on the scope and extent of this problem. Objective: The aim of this study was to describe outpatient antimicrobial drug prescribing at the National Health Insurance Scheme (NHIS) unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methodology: This was a descriptive drug utilization study carried out prospectively during a 2 week period in May 2015. Six objective World Health Organization (WHO) indicators were used to assess the rationality of antimicrobial prescribing at the site. Data collected on antimicrobials included type, route of administration, dose and dosing frequency as well as length of therapy. Average costs (both prescription and antibiotic) were obtained by dividing...
A point prevalence survey of antimicrobial prescribing in four Nigerian Tertiary Hospitals
Annals of Tropical Pathology
IntroductIon Antimicrobial resistance (AMR) is currently of global significance, with increasing number of microorganisms exhibiting resistance to available antimicrobial agents. [1-4] It involves both the Gram-positive and Gram-negative bacteria, with global prevalence rates as high as 60% or more. [5-10] This resistance is particularly higher in hospital-acquired strains. [11] To combat this rise in AMR, the World Health Organization (WHO) advocates the adoption of antimicrobial stewardship by health-care providers to check and reduce the burden of antibiotic resistance. [12,13] This strategy involves the application of objective interventions to influence prescribing practices, thereby promoting rationale and appropriate antimicrobial use. [14,15] This intervention is vital in the developing countries which usually have a combination of poor antimicrobial-prescribing practices, unregulated over-the-counter sale of antibiotics, and increasing rates of AMR. [16-22] However, before any antimicrobial stewardship program can be implemented, antimicrobial prescribing information is required; this information is currently scanty in Nigeria. [16,23-25] To obtain objective and reproducible information on antimicrobial prescription, a uniform and standardized method of data collection needs to be applied. Point prevalence survey (PPS) has been a popular and widely accepted method for over 20 years [26-29] because it is less expensive, less time-consuming, and easier to conduct than incidence studies [28,30] and can be used to identify and assess quality indicators [31-33] to evaluate problems of antibiotic use and resolve prescribing issues. Introduction: Antimicrobial resistance has become a global challenge in health care. Its emergence in previously sensitive bacteria is usually associated with poor antibiotic-prescribing patterns. Methodology: A point prevalence survey was carried out in four tertiary hospitals in Nigeria in 2015 to determine the rate and characteristics of antibiotic prescription. Results: Of 828 patients eligible for the study, 69.7% received antibiotics, with highest rates in the adult Intensive Care Unit. There were therapeutic indications in 51.2% of the prescriptions, of which 89.5% were for community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. On the evaluation of surgical prophylaxis, only 4.1% were compliant with institutional guidelines and 39.2% gave a reason for prescribing in patient case notes. Less than 1% of the prescriptions were based on the use of biomarkers. Conclusion: The prevalence of antibiotic prescription in Nigerian hospitals is high with only about 50% of prescriptions based on clear therapeutic indications. We provide evidence that the country needs to institute a cohesive antimicrobial stewardship intervention program.
Assessment of Rational Antibiotic Prescribing in Public Hospitals in Nasarawa State, Nigeria
European Journal of Biology and Biotechnology, 2020
Antibiotics are the most commonly used medicines in healthcare facilities globally; and they are often misused, especially in developing countries. Periodic assessment of antibiotic prescribing practices is essential to improve prescribing standards and ensure rational use. A cross-sectional, retrospective evaluation of antibiotic prescribing in public secondary and tertiary hospitals in Nasarawa State, Nigeria was carried out. A total of 2800 case sheets of patients who accessed the hospitals under review during the period 2008-2018 were randomly sampled and evaluated. Prescribing indicators of World Health Organization (WHO) and Strengthening Pharmaceutical System/United States Agency for International Development (SPS/USAID) were evaluated and compared with published standards for each of the indicators to identify irrational antibiotic use. Percentage of hospitalization with one or more antimicrobials prescribed was 75.6%. Average number of antimicrobials prescribed per hospital...
Antimicrobial Resistance and Infection Control, 2021
Background As part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physicians in tertiary hospitals in Nigeria, and to determine predictors of KAP of APR and AMR. Methods In this cross-sectional study, we enrolled physicians practicing in tertiary hospitals from all six geopolitical zones of Nigeria. Implementation of an antimicrobial stewardship programmes (ASP) by each selected hospital were assessed using a 12 item ASP checklist. We used a structured self-administered questionnaire to assess the KAP of APR and AMR. Frequency of prescriptions of 18 different antibiotics in the prior 6 months was assessed using a Likert’s scale. KAP and prescription (Pr) scores were classified as good (score ≥ 80%) or average/p...
Pan African Medical Journal, 2019
Introduction: antimicrobials are among the most commonly prescribed therapeutic agents in hospitals. Irrational use of antimicrobials resul ts in the development of antimicrobial resistance which could lead to life-threatening illnesses. Therefore, the assessment of antimicrobial prescribing and use is of utmost importance. This study aimed to examine the prescribing patterns of antimicrobials in the Internal Medicine Department of Ibrahim Malik Teaching Hospital in Khartoum, Sudan. Methods: a descriptive, cross-sectional study was conducted using World Health Organization (WHO) indicators for antimicrobial use in hospitals. Systematic random sampling was used to select 245 medical records from the 261 3 medical records of patients admitted to the internal medicine department in 2016. Data were collected using a data collection form and a structured interview with the chief pharmacist in the hospital. Results: of the 245 medical records examined, 201 (82%) patients were prescribed one or more antimicrobial drug. The average number of antimicrobials per patient was (2.1±1.1). The average duration of antimicrobial treatment was (4.9±3.8) days. The g eneric name was used in (35.6%) of antimicrobials, while (95.5%) of all antimicrobials were prescribed from the national essential medicines list. Overall, there were 421 courses of antimicrobials prescribed. The most frequently prescribed antimicrobials were ceftriaxone (131 courses) and metronidazole (89 courses). Among the documented infectious diseases, the most frequently encountered was pneumonia, followed by malaria. There was no drug and therapeutic committee, hospital formulary or essential medicines list, and standard treatment guidelines for infectious diseases in the hospital. Conclusion: the results of the study revealed a high percentage of antimicrobial use in the Internal Medicine Department. Multifaceted interventions are urgently needed to promote rational prescribing of antimicrobials.
Retrospective Antibiotic Prescription Pattern in Public Hospitals in Nasarawa State, Nigeria
World Journal of Innovative Research, 2020
Antibiotics are the most frequently used group of drugs in healthcare delivery. Their usage pattern varies between countries and healthcare facilities. Hence, the assessment of their usage pattern in healthcare facilities is pivotal to the successful management of infectious diseases. A descriptive retrospective cross-sectional study on antibiotic prescription pattern in public hospitals in Nasarawa State, Nigeria was carried out. A total of 2800 case sheets of patients which accessed public hospitals during the period of 10 years (2008-2018) were randomly sampled and reviewed. The socio-demographic data of the patients in the case sheets were also collected. Antibiotic use by the patients and the use in relation to their socio-demographic factors were determined using descriptive statistics. The overall percentage antibiotic use in Nasarawa State was 45.8%. Nasarawa West (64.4%) had highest use; while Nasarawa South (52.7%) was the lowest. More females (63.4%) than males (61.3%) used antibiotics. Highest use was observed at age 0-10 yr (67.0%); and lowest at >50 yr (49.9%). More in-patients (75.6%) than outpatients (52.7%) used antibiotics. Ciprofloxacin (28.0%) was the most commonly used antibiotic; and streptomycin (0.4%) was the least used. More oral antibiotics (63.4%) than injectables (36.4%) were used. the antibiotic use in typhoid fever (39.8%) was highest; and lowest in eye infections (0.5%). The percentage used of antibiotics under the period reviewed was high and antibiotics namely; ciprofloxacin, gentamicin and metronidazole were most common antibiotic prescribed.
2020
Background: Antibiotics are among the most common drugs used worldwide.They kill or prevent the growth of bacterial microorganisms in the body, hence, they are the major agents used in treating bacterial infections. Because they are prone to abuse and misuse, regular evaluation of their utilization is important for optimal healthcare delivery.Objective: This study determined the antibiotics type, utilization, prescriptions and cost patterns in the adult out-patient pharmacy of a public tertiary health facility in Nigeria.Methods: This is a retrospective observational study using medication utilization records (prescriptions) to investigate the study objectives. Prescriptions dispensed in 2018 in adult out-patient pharmacy of Nnamdi Azikiwe University Teaching Hospital, Nnewi were reviewed. Data were evaluated using the World Health Organization-developed prescribing indicators. Descriptive and inferential statistics were used to analyze the results. The percentage and averages of th...
Journal of complementary and alternative medical research, 2023
Background: The consequences of antimicrobial resistance are severe, as mortality and morbidity rates continue to increase. The extensive use of antibiotics contributes significantly to the development and spread of antimicrobial resistance. It is crucial to have knowledge supported by data to improve antimicrobial stewardship and address the growing problem of antimicrobial resistance globally and locally. Thus, an evaluation was conducted to assess the prescription practices of doctors working in private medical facilities in Port Harcourt, Rivers state, Nigeria. Methods: A cross-sectional survey was carried out using a structured questionnaire to collect information on medical training and antibiotic prescription practices among 102 medical doctors.
Antibiotic utilization study in a teaching hospital in Nigeria
JAC-Antimicrobial Resistance
Background Antibiotics have been the bedrock of modern medical care, particularly bacterial infections. However, globally, antimicrobial resistance has become a well-recognized public health threat in recent years, and interventions to reduce its burden have been launched worldwide. Objectives The present study evaluated antibiotic utilization in both hospitalized patients and outpatients in a University Hospital in Nigeria. Methods In a 3 year retrospective study between January 2017 and December 2019, 246 case files of patients were selected for the study based on inclusion and exclusion criteria. In addition, the antibiotic consumption rate for hospitalized and outpatients was determined. Results The total antibiotic consumption for hospitalized patients in this study was 260.9 DDD/100 bed-days, while the outpatient department’s patients were 72.3 DDD/1000 inhabitants per day. Peptic ulcer disease was the most frequent indication for antibiotic use for outpatients, with the fluor...
Antibiotic Prescription Profiles in some Health Institutions in Kebbi State, Nigeria
Journal of Pharmaceutical Research, 2014
The study was undertaken to evaluate antibiotic prescription pattern and usage in some health institutions in Kebbi State. This retrospective analysis of antibiotic prescription was carried out by assessing patients' medical records in ve general hospitals and a private hospital located in different regions in the state. Records such as age of patients, diagnosis, types of antibiotics prescribed & duration and type of test performed before antibiotics were prescribed were collated and analyzed. The result showed that 46.10% of the patients who visited those hospitals were prescribed antibiotics. Predominantly higher proportion of adults was prescribed antibiotics than children and more males were prescribed antibiotics than females. Culture and sensitivity tests were hardly performed in the hospitals. The predominant infection requiring antibiotic prescription was gastrointestinal in nature accounting for over 25% of infections in which antibiotics were prescribed. Regrettably however, majority of prescriptions containing antibiotics did not show any specic diagnosis rather only symptoms were recorded. The vastly employed antimicrobial agents across the six health institutions were β-lactams and metronidazole; and about half of the total number of cases did not show a treatment regimen of up to ve days. However, combination therapy is very common with an average overall percentage of 62.89%.