TITLE:
Antibiotic Prescription in the Neurology Department of the Brazzaville University Hospital (Congo): Effectiveness and Factors Associated with Treatment Failure
AUTHORS:
Ghislain Armel Mpandzou, Prince Eliot Galiéni Sounga Bandzouzi, Manon Melissa Gakosso, Dinah Happhia Motoula Latou, Josué Euberma Diatewa, Yacoub Kaba, Karen Lise Obondzo Aloba, Paul Macaire Ossou-Nguiet
KEYWORDS:
Antibiotics, Healthcare-Associated Infections, Adherence, Antimicrobial Resistance, Neurology, Congo
JOURNAL NAME:
World Journal of Neuroscience,
Vol.15 No.4,
September
18,
2025
ABSTRACT: Introduction: The rational use of antibiotics is critical to curb antimicrobial resistance. In neurology, healthcare-associated infections (HAIs) are frequent and require optimized prescribing. Objective: To assess the effectiveness of antibiotic therapy and identify factors associated with treatment failure in the neurology department of the Brazzaville University Hospital. Methods: This cross-sectional study (February-October 2024) included 115 adult patients with an infectious syndrome during hospitalization who received antibiotic therapy prescribed in the department. Sociodemographic, clinical, microbiological, therapeutic, and outcome data were collected prospectively. Treatment failure was defined as persistent fever or death. Variables with p Results: The mean age was 61.4 ± 14.5 years; sex ratio, 1.01. Stroke was the leading diagnosis (93.9%). Main infection sites were bronchopulmonary (52.7%) and urinary (35.5%). First-line therapy was mainly empirical (94.8%), most often ceftriaxone plus metronidazole (79.1%), with 64.4% effectiveness. Effectiveness was 77.8% for second-line, and 50% for third-line regimens. Independent predictors of first-line failure included unemployment (OR = 7.97; p Conclusion: Antibiotic effectiveness in neurology is moderate, influenced by clinical, organizational, and socioeconomic factors. Strengthening guideline compliance, expanding access to microbiological testing, and reducing self-medication are essential to improve outcomes and limiting resistance.