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. 2022 Feb 4;11(2):199.
doi: 10.3390/antibiotics11020199.

Point Prevalence Survey of Antibiotic Use across 13 Hospitals in Uganda

Reuben Kiggundu  1 , Rachel Wittenauer  2 , J P Waswa  1 , Hilma N Nakambale  3 , Freddy Eric Kitutu  4 , Marion Murungi  1 , Neville Okuna  5 , Seru Morries  5 , Lynn Lieberman Lawry  6 , Mohan P Joshi  7 , Andy Stergachis  2   3 , Niranjan Konduri  7
Affiliations

Point Prevalence Survey of Antibiotic Use across 13 Hospitals in Uganda

Reuben Kiggundu et al. Antibiotics (Basel). .

Abstract

Standardized monitoring of antibiotic use underpins the effective implementation of antimicrobial stewardship interventions in combatting antimicrobial resistance (AMR). To date, few studies have assessed antibiotic use in hospitals in Uganda to identify gaps that require intervention. This study applied the World Health Organization's standardized point prevalence survey methodology to assess antibiotic use in 13 public and private not-for-profit hospitals across the country. Data for 1077 patients and 1387 prescriptions were collected between December 2020 and April 2021 and analyzed to understand the characteristics of antibiotic use and the prevalence of the types of antibiotics to assess compliance with Uganda Clinical Guidelines; and classify antibiotics according to the WHO Access, Watch, and Reserve classification. This study found that 74% of patients were on one or more antibiotics. Compliance with Uganda Clinical Guidelines was low (30%); Watch-classified antibiotics were used to a high degree (44% of prescriptions), mainly driven by the wide use of ceftriaxone, which was the most frequently used antibiotic (37% of prescriptions). The results of this study identify key areas for the improvement of antimicrobial stewardship in Uganda and are important benchmarks for future evaluations.

Keywords: Uganda; antibiotic use surveillance; antimicrobial stewardship; antimicrobials; global health security; hospital; point prevalence survey; private sector.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Geographic location of study sites and number of hospital beds.
Figure 2
Figure 2
Top three antibiotics prescribed for various diagnoses and their AWaRe classification. Notes: 1 WHO AWaRe classification for antibiotics: ■ Access, ■ Watch, ■ Reserve, ■ not classified. 2 First-line treatment recommendation from the Uganda Clinical Guidelines 2016: ampicillin and gentamicin. 3 First-line treatment recommendation: cloxacillin. 4 First-line treatment recommendation: ampicillin and gentamicin (for children < 5yrs) or benzylpenicillin (for older children and adults). 5 First-line treatment recommendation: ceftriaxone and metronidazole, gentamycin (optional). 6 First-line treatment recommendation: nitrofurantoin or ciprofloxacin. 7 First-line treatment recommendation: ampicillin, gentamicin, and metronidazole.
Figure 3
Figure 3
Prescriptions by AWaRe classification per hospital.
See this image and copyright information in PMC

References

    1. Naylor N.R., Atun R., Zhu N., Kulasabanathan K., Silva S., Chatterjee A., Knight G.M., Robotham J.V. Estimating the burden of antimicrobial resistance: A systematic literature review. Antimicrob. Resist. Infect. Control. 2018;7:58. doi: 10.1186/s13756-018-0336-y. - DOI - PMC - PubMed
    1. Hay S.I., Rao P.C., Dolecek C., Day N.P.J., Stergachis A., Lopez A.D., Murray C.J.L. Measuring and mapping the global burden of antimicrobial resistance. BMC Med. 2018;16:78. doi: 10.1186/s12916-018-1073-z. - DOI - PMC - PubMed
    1. Hernando-Amado S., Coque T.M., Baquero F., Martínez J.L. Defining and combating antibiotic resistance from One Health and Global Health perspectives. Nat. Microbiol. 2019;4:1432–1442. doi: 10.1038/s41564-019-0503-9. - DOI - PubMed
    1. O’Neill J. Review on Antimicrobial Resistance Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations. London: Review on Antimicrobial Resistance. 2014. [(accessed on 21 December 2021)]. Available online: https://amr-review.org/Publications.html.
    1. Getahun H., Smith I., Trivedi K., Paulin S., Balkhy H.H. Tackling antimicrobial resistance in the COVID-19 pandemic. Bull. World Health Organ. 2020;98:442. doi: 10.2471/BLT.20.268573. - DOI - PMC - PubMed

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