Antibiotic prescribing in paediatric inpatients in Ghana: a multi-centre point prevalence survey

Appiah-Korang Labi,Noah Obeng-Nkrumah,Mercy Jemima Newman,Gifty Sunkwa-Mills,Antoinette Bediako-Bowan,Christiana Akufo,Christabel Enweronu-Laryea,Japheth Awuletey Opintan,Enid Owusu,Stephanie Bjerrum,Jorgen Anders Lindholm Kurtzhals

doi:10.1186/s12887-018-1367-5

Abstract

BackgroundExcessive and inappropriate use of antibiotics in hospitalised patients contributes to the development and spread of antibiotic resistance. Implementing a stewardship programme to curb the problem requires information on antibiotic use. This study describes a multicentre point prevalence of antibiotic use among paediatric inpatients in Ghana.MethodsData were extracted from a multicentre point prevalence survey of hospital acquired infections in Ghana. Data were collected between September 2016 and December 2016 from ten hospitals through inpatient folder and chart reviews using European Centre for Disease Control (ECDC) adapted data collection instrument. From each site, data were collected within a 12-h period (8 am to 8 pm) by a primary team of research investigators and a select group of health professionals from each participating hospital.ResultsAmong 716 paediatric inpatients, 506 (70.6%; 95% confidence interval (CI): 67.2 to 74.0%) were on antibiotics. A significant proportion of antibiotics (82.9%) was prescribed for infants compared to neonates (63.9%) and adolescents (60.0%). The majority of patients (n = 251, 49.6%) were prescribed two antibiotics at the time of the survey. The top five classes of antibiotics prescribed were third generation cephalosporins (n = 154, 18.5%) aminoglycosides (n = 149, 17.9%), second generation cephalosporins (n = 103,12.4%), beta lactam resistant penicillins (n = 83, 10.0%) and nitroimidazoles (n = 82, 9.9%). The majority of antibiotics (n = 508, 61.0%) were prescribed for community acquired infections. The top three agents for managing community acquired infections were ceftriaxone (n = 97, 19.1%), gentamicin (n = 85, 16.7%) and cefuroxime (n = 73, 14.4%).ConclusionThis study points to high use of antibiotics among paediatric inpatients in Ghana. Cephalosporin use may offer an important target for reduction through antibiotic stewardship programmes.

Highlights

Excessive and inappropriate use of antibiotics in hospitalised patients contributes to the development and spread of antibiotic resistance
This study describes antibiotic prescribing patterns among hospitalised children and adolescents in Ghana using data from a multicentre point prevalence survey conducted between September and December 2016 [22]
Study design and population The report presented here on antibiotic use in patients ≤18 years is a sub-analysis to a multicentre point prevalence survey of hospital acquired infections

Summary

Introduction

Excessive and inappropriate use of antibiotics in hospitalised patients contributes to the development and spread of antibiotic resistance. This study describes a multicentre point prevalence of antibiotic use among paediatric inpatients in Ghana. Antibiotic resistance is a public health threat of global proportions [1] It is associated with increased costs of health services, prolonged hospital stays and poor clinical outcomes [2, 3]. There are increasing reports of antibiotic resistance in hospital-acquired as well as Antibiotic resistance, though a natural phenomenon, has been accentuated by inappropriate use of antibiotics which selects for and contributes to the spread of. This study describes antibiotic prescribing patterns among hospitalised children and adolescents in Ghana using data from a multicentre point prevalence survey conducted between September and December 2016 [22]. We describe antibiotic use across paediatric age groups and hospital levels, indications for antibiotic use, and targets for improved antibiotic use within the population

Methods

Results

Discussion

Conclusion