A Point Prevalence Survey of Antibiotic Prescribing in three Nigerian public children’s hospitals.

Abstract

Background: Antibiotic resistance continues to impact public health globally hence the need to monitor antibiotic use in hospitals and  in children in order to identify gaps in prescribing practices for possible intervention. This study investigated the prevalence and  characteristics of antibiotic prescribing in three government hospitals in Lagos Nigeria in November/December 2015 using the Global point prevalence survey of antimicrobial consumption and resistance (G-PPS) as a tool. Data were analysed using the Statistical  Package for Social Sciences (SPSS) software version 22. Results: Of the 207 inpatients, 180 (87%) were prescribed at least one antibiotic  during the survey period. Furthermore, 81% and 89.3% of neonates and paediatric patients respectively were on antibiotics. The most  commonly prescribed antibiotic class for neonates were the aminoglycosides (38.1%) and the third- generation cephalosporins (31%).  In paediatric patients, the third-generation cephalosporins were the most prescribed (26.2%). Most common diagnosis in neonates  was sepsis (38.3%) while lower respiratory tract infections (25.7%) were most occurring in paediatric patients. Community acquired  infections were the most common indications for prescribing accounting for 48.8% and 56.6% of neonatal and paediatric prescriptions  respectively. Overall, parenteral antibiotic accounted for 96.4% and 80.5% of antibiotics prescribed for neonates and paediatric  patients. Targeted antibiotic prescribing was observed in 8.3% and 5.8% of neonatal and paediatric prescriptions. Furthermore, biomarker was used to guide prescribing in only 1.2 % of neonatal prescriptions. Antibiotic stop /review dates were documented in  11.9% and 12.5% of neonatal and paediatric prescriptions. Conclusion: A high prevalence of antibiotic prescribing was observed in the  surveyed children's hospitals. The high use of third generation cephalosporins, the predominant use of parenteral antibiotic  formulations and the low documentation of stop review dates were among the identified areas for improving prescribing practices at  these hospitals. The identified gaps can form the basis for implementing Antibiotic Stewardship Interventions in the hospitals of study.   &nbsp