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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report
BMC Infectious Diseases, Volume 23, No. 1, Article 737, Year 2023
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Description
Background: Although one of the main drivers of antimicrobial resistance is inappropriate antibiotic prescribing, there are limited resources to support the surveillance of antibiotic consumption in low-income countries. In this study, we aimed to assess antibiotic use and consumption among medical patients of two hospitals in different geographic regions of Sierra Leone. Methods: This is a cross-sectional study of adult (18 years or older) patients receiving medical care at two hospitals (34 Military Hospital-MH and Makeni Government Hospital-MGH) between March 2021 and October 2021. After admission to the medical or intensive care unit, patients were sequentially recruited by a nurse from each hospital. Demographic and clinical characteristics and information on the dose of antibiotics, their routes, and frequency of administration and duration were collected using a questionnaire adapted from previous studies and encrypted in EpiCollect software (Epic, Verona WI). A physician reviews and verifies each completed questionnaire. Data analysis was done using STATA version 16. Results: The mean age of the 468 patients evaluated in this study was 48.6 years. The majority were women (241, 51.7%) and treated at MGH (245, 52.0%). Clinical diagnosis of bacterial infection was made in only 180 (38.5%) patients. Regardless of the diagnosis, most (442, 94.9%) patients received at least one antibiotic. Of a total 813 doses of antibiotics prescribed by the two hospitals, 424 (52.2%) were administered in MH. Overall, antibiotic consumption was 66.9 defined daily doses (DDDs) per 100 bed-days, with ceftriaxone being the most commonly used antibiotic (277, 34.1%). The ACCESS and WATCH antibiotics accounted for 18.9 DDDs per 100 bed-days (28.2%) and 48.0 DDDs per 100 bed-days (71.7%), respectively. None of the patients were prescribed a RESERVE antibiotics. The antibiotic consumption was lower in MH (61.3 DDDs per 100 bed-days) than MGH (76.5 DDDs per 100 bed-days). Conclusion: Antibiotic consumption was highest with ceftriaxone, followed by levofloxacin and metronidazole. Given the high rate of consumption of antibiotics in the WATCH category of the AWaRe classification, there is a need to initiate surveillance of antibiotic consumption and establish hospital-based antibiotic stewardship in these settings. © 2023, The Author(s).
Authors & Co-Authors
Lakoh, Sulaiman
Sierra Leone, Freetown
University of Sierra Leone
Sierra Leone, Freetown
Sustainable Health Systems
Sierra Leone, Freetown
Infectious Disease Research Network
Williams, Christine Ellen Elleanor
Sierra Leone, Freetown
University of Sierra Leone
Sevalie, Stephen S.
Sierra Leone, Freetown
University of Sierra Leone
Sierra Leone, Freetown
Sustainable Health Systems
Sierra Leone, Freetown
34 Military Hospital
Russell, James Baligeh Walter
Sierra Leone, Freetown
University of Sierra Leone
Kanu, Joseph Sam
Sierra Leone, Freetown
University of Sierra Leone
Barrie, Umu
Sierra Leone, Freetown
Infectious Disease Research Network
Deen, Gibrilla Fadlu
Sierra Leone, Freetown
University of Sierra Leone
Maruta, Anna
Switzerland, Geneva
Organisation Mondiale de la Santé
Sesay, Daniel
Unknown Affiliation
Adekanmbi, Olukemi A.
Nigeria, Ibadan
University of Ibadan
Nigeria, Ibadan
University College Hospital, Ibadan
Jiba, Darlinda F.
Unknown Affiliation
Okeibunor, Joseph Chukwudi
Switzerland, Geneva
Organisation Mondiale de la Santé
Yendewa, George A.
United States, Cleveland
Case School of Medicine
United States, Cleveland
University Hospitals Case Medical Center
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Firima, Emmanuel
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Lesotho, Maseru
Solidarmed
Nigeria, Abuja
Centre for Multidisciplinary Research and Innovation
Statistics
Authors: 14
Affiliations: 14
Identifiers
Doi:
10.1186/s12879-023-08517-0
ISSN:
14712334
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Sierra Leone
Participants Gender
Female