Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 22;6(1):dlae023.
doi: 10.1093/jacamr/dlae023. eCollection 2024 Feb.

Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications

Steward Mudenda  1 , Robert Chilimboyi  1   2 , Scott Kaba Matafwali  3 , Victor Daka  4 , Ruth Lindizyani Mfune  4 , Loriane Arielle Mobou Kemgne  5 , Flavien Nsoni Bumbangi  6 , Jimmy Hangoma  7 , Billy Chabalenge  8 , Larry Mweetwa  9 , Brian Godman  10   11
Affiliations

Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications

Steward Mudenda et al. JAC Antimicrob Resist. .

Abstract

Background: Antimicrobial resistance (AMR) is a global public health problem that is fuelled by the inappropriate prescribing of antibiotics, especially those from the 'watch' and 'reserve' antibiotic lists. The irrational prescribing of antibiotics is particularly prevalent in developing countries, including Zambia. Consequently, there is a need to better understand prescribing patterns across sectors in Zambia as a basis for future interventions. This study evaluated the prescribing patterns of antibiotics using the WHO prescribing indicators alongside the 'access, watch and reserve' (AWaRe) classification system post-COVID pandemic at a faith-based hospital in Zambia.

Methods: A cross-sectional study was conducted from August 2023 to October 2023 involving the review of medical records at St. Francis' Mission Hospital in Zambia. A WHO-validated tool was used to evaluate antibiotic prescribing patterns alongside the AWaRe classification tool.

Results: Out of 800 medical records reviewed, 2003 medicines were prescribed. Each patient received an average of 2.5 medicines per prescription. Antibiotics were prescribed in 72.3% of encounters, of which 28.4% were injectable. The most frequently prescribed antibiotics were amoxicillin (23.4%-access), metronidazole (17.1%-access), ciprofloxacin (8%-watch) and ceftriaxone (7.4%-watch), with 77.1% overall from the 'access' list. Encouragingly, 96.5% of the medicines were prescribed by their generic names and 98% were from the Zambia Essential Medicines List.

Conclusions: There were high rates of antibiotic prescribing, including injectable antibiotics, which needs addressing going forward. It is crucial to implement targeted measures, including antimicrobial stewardship programmes, to improve future antibiotic prescribing in Zambia and reduce the risk of AMR.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Structure of the healthcare and referral system in Zambia. Source: Songiso et al.
Figure 2.
Figure 2.
Number of medicines prescribed per encounter at Saint Francis’ Hospital, Zambia: January 2023—June 2023.
Figure 3.
Figure 3.
Number of antibiotics prescribed per encounter at Saint Francis’ Hospital, Zambia: January 2023—June 2023.
Figure 4.
Figure 4.
Percentage distribution of commonly prescribed antibiotics by class at Saint Francis’ Hospital, Zambia: January 2023—June 2023.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sartelli M, Barie PS, Coccolini F et al. Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action. World J Emerg Surg 2023; 18: 50. 10.1186/s13017-023-00518-3 - DOI - PMC - PubMed
    1. Adedeji WA. The treasure called antibiotics. Ann Ibadan Postgrad Med 2016; 14: 56–7. - PMC - PubMed
    1. Spellberg B. The future of antibiotics. Crit Care 2014; 18: 228. 10.1186/cc13948 - DOI - PMC - PubMed
    1. Yimenu DK, Emam A, Elemineh E et al. Assessment of antibiotic prescribing patterns at outpatient pharmacy using World Health Organization prescribing indicators. J Prim Care Community Health 2019; 10: 2150132719886942. 10.1177/2150132719886942 - DOI - PMC - PubMed
    1. Browne AJ, Chipeta MG, Haines-Woodhouse G et al. Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study. Lancet Planet Health 2021; 5: e893–904. 10.1016/S2542-5196(21)00280-1 - DOI - PMC - PubMed

LinkOut - more resources