Antimicrobial use in hospitalized patients: a multicentre point prevalence survey across seven hospitals in Ghana
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
JAC Antimicrob Resist
Abstract
Background: Antimicrobial resistance (AMR) is a public health crisis of global proportions. Data is required
to understand the local drivers of antimicrobial resistance and support decision-making processes including
implementation of appropriate antimicrobial stewardship strategies.
Objectives: To measure antimicrobial usage in hospitals in Ghana.
Methods: Using the Global Point Prevalence instruments and processes, we conducted point prevalence surveys
across AMR surveillance sentinel hospitals in Ghana, between September and December 2019. Hospital records
of all inpatients on admission at 0800 hours on a specific day were reviewed for antimicrobial use at the time of
the survey. Data on antibiotic use, including indication for use and quality of prescribing were recorded.
Results: Overall prevalence of antibiotic use across the sentinel sites was 54.9% (n " 1591/2897), ranging be tween 48.4% (n " 266/550) and 67.2% (n " 82/122). The highest prevalence of antibiotic use 89.3% (n " 25/28)
was observed in adult ICUs. The average number of antibiotics prescribed per patient was 1.7 (n " 1562/2620),
with the majority (66%, n " 728/2620) administered via the parenteral route. The five most-commonly used
antibiotics were metronidazole (20.6%, n " 541/2620), cefuroxime (12.9%, n " 338/2620), ceftriaxone (11.8%,
n " 310/2620), amoxicillin/clavulanic acid (8.8%, n " 231/2620) and ciprofloxacin (7.8%, n " 204/2620). The
majority (52.2%; n " 1367/2620) of antibiotics were prescribed to treat an infection, whilst surgical prophylaxis
accounted for 26.1% (n " 684/2620).
Conclusions: We observed a high use of antibiotics including metronidazole and cephalosporins at the
participating hospitals. Most antibiotics were empirically prescribed, with low use of microbiological cultures.
High usage of third-generation cephalosporins especially for community-acquired infections offers an opportun ity for antibiotic stewardship interventions.
Description
Research Article
Keywords
Antimicrobial, hospitalized patients, Ghana