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Towards an Antimicrobial Stewardship Program in a Young Tertiary Hospital in Southern Nigeria: A Point Prevalence Survey of Antimicrobial Usage

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Open Journal of Medical Microbiology 2023年第4期13卷 292-302页

作者： Ibinabo Laura Oboro Mienye Bob-Manuel Datonye Christopher Briggs Afam Chibuike Okafor Simeon Chijioke Amadi stella ogbonnie enyinnaya Stephenson Danagogo Lawson Oyinlola Omoniyi Oduyebo Department of Medical Microbiology and Parasitology Rivers State University Teaching Hospital Port Harcourt Nigeria Department of Paediatrics Rivers State University Teaching Hospital Port Harcourt Nigeria Department of Obstetrics and Gynaecology Rivers State University Teaching Hospital Port Harcourt Nigeria Department of Medical Microbiology and Parasitology Lagos University Teaching Hospital Lagos Nigeria

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 patter

关键词： Antimicrobial Stewardship Antimicrobial Resistance Point Prevalence Survey Rivers State University Teaching Hospital

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