Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications. Issue 7 (3rd July 2019)

• Record Type: Journal Article
• Authors: Anand Paramadhas, Bene D.; Tiroyakgosi, Celda; Mpinda-Joseph, Pinkie; Morokotso, Mathudi; Matome, Matshediso; Sinkala, Fatima; Gaolebe, Mavis; Malone, Brighid; Molosiwa, Emmanuel; Shanmugam, Muthu Guhan; Raseatlholo, Gogaisa Pearl; Masilo, Joyce; Oyeniran, Yomi; Marumoloa, Stella; Maakelo, Omphile Glory; Katjakae, Ishmael; Kgatlwane, Joyce; Godman, Brian; Massele, Amos
• Is Part Of: Expert review of anti-infective therapy. Volume 17:Issue 7(2019)
• Page Start: 535
• Page End: 546
• Publication Date: 2019-07-03
• Subjects: Antibiotics -- Botswana -- point prevalence studies -- hospitals -- drugs and therapeutic committees -- antimicrobial stewardship programs -- antimicrobial resistance -- antimicrobial utilization; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1080/14787210.2019.1629288
• Languages: English
• ISSNs: 1478-7210

Abstract

ABSTRACT: Objective : There is an urgent need to undertake Point Prevalence Surveys (PPS) across Africa to document antimicrobial utilisation rates given high rates of infectious diseases and growing resistance rates. This is the case in Botswana along with high empiric use and extended prophylaxis to prevent surgical site infections (SSIs) Method : PPS was conducted among all hospital sectors in Botswana using forms based on Global and European PPS studies adapted for Botswana, including rates of HIV, TB, malaria, and malnutrition. Quantitative study to assess the capacity to promote appropriate antibiotic prescribing. Results : 711 patients were enrolled with high antimicrobial use (70.6%) reflecting an appreciable number transferred from other hospitals (42.9%), high HIV rates (40.04% among those with known HIV) and TB (25.4%), and high use of catheters. Most infections were community acquired (61.7%). Cefotaxime and metronidazole were the most prescribed in public hospitals with ceftriaxone the most prescribed antimicrobial in private hospitals. Concerns with missed antibiotic doses (1.96 per patient), high empiric use, extended use to prevent SSIs, high use of IV antibiotics, and variable infrastructures in hospitals to improve future antibiotic use. Conclusion : High antibiotic use reflects high rates of infectious diseases observed in Botswana. A number of concerns have been identified, which are being addressed.