TITLE:
Towards an Antimicrobial Stewardship Program in a Young Tertiary Hospital in Southern Nigeria: A Point Prevalence Survey of Antimicrobial Usage
AUTHORS:
Ibinabo Laura Oboro, Mienye Bob-Manuel, Datonye Christopher Briggs, Afam Chibuike Okafor, Simeon Chijioke Amadi, Stella Ogbonnie Enyinnaya, Stephenson Danagogo Lawson, Oyinlola Omoniyi Oduyebo
KEYWORDS:
Antimicrobial Stewardship, Antimicrobial Resistance, Point Prevalence Survey, Rivers State University Teaching Hospital
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.13 No.4,
December
28,
2023
ABSTRACT: Background: Antimicrobial
resistance (AMR) is one of the top 10 global public health threats facing
humanity and this burden is borne largely by low and middle-income countries.
As part of efforts to combat AMR, the World Health Organization has identified
Antimicrobial Stewardship as one of the strategic objectives of its global
action plan on antimicrobial resistance. This survey aimed to observe
antimicrobial prescribing and usage patterns in the Rivers State University
Teaching Hospital with the purpose of identifying gaps to inform the specific
antimicrobial stewardship interventions necessary to address our specific
needs. Methodology: A point prevalence survey was conducted using the
protocol and web-based automated data management system designed by the Global
Point Prevalence Survey of Antimicrobial Consumption and Resistance, University
of Antwerp, Belgium, in November 2021. Results: A total of 69 adult
medical and surgical patients were surveyed; 27 males and 18 females.
Antimicrobial prevalence was 65.2%. Third generation cephalosporins (24.4%;
33.3%), fluoroquinolones (17.8%; 22.2%) and imidazole derivatives (20%; 36.1%)
were most prescribed on the medical and surgical wards. Antimicrobial
guidelines were completely unavailable, most antimicrobials (93.8%) were
prescribed empirically and 64.4% of these remained empirical after 72 hours of
commencement. Conclusion: Antimicrobial stewardship interventions are
necessary to minimize sub-optimal antimicrobial prescribing practices in our
facility. Most critical are education on appropriate use of antimicrobials,
support for development of antimicrobial guidelines, diagnostic stewardship,
and the drive for improved use of the laboratory to guide antimicrobial
prescriptions. The antimicrobial stewardship committee and team must drive
this, having the requisite support from the management and prescribers, with
the primary outcomes being reduced antimicrobial prevalence and improved
antimicrobial prescription patterns.