ANTIBIOTIC USAGE IN THE INTENSIVE CARE UNIT SETTING IN MALI

Abstract

Antibiotics remains an issue in intensive care units (ICUs), because of its overuse and the emergence of bacterial resistance. The objective of the study was to evaluate the prescription of antibiotics in ICUs at university teaching and the regional hospitals in Mali. PATIENTS AND METHODS: It was a cross sectorial retrospective and multicentric study over six months. The inclusion criteria were, all the patients hospitalized in ICUs at least for 48 hours with antibiotic treatment. We also included the cost of the daily consumption of antibiotics. The Microsoft excel was used for data entry and the data analysis was done with the software Epi info version 3.5.2. RESULTS: Five hundred sixty-and-six (566) patient les responded to the inclusion criteria. The antibiotics prescription rate was 43.3%. The mean age of the patients was 36.8 ± 20.7. The women were more represented (59.7%). The monotherapy (60.6%) was the most common concept use. The third-generation cephalosporin (3GC) was used in monotherapy (27.7%). The average volume of consumption of antibiotics in monotherapy was the highest. The analysis of the data showed that the volume consumption of antibiotics was different according to grade of the prescribers which was respectively 98972.3 for anaesthesia & intensive care residents and 74990.7 for anaesthetist-intensivist. The treatment was reviewed during the rst 48 hours (99.8%) and was readapted in 106 of the patients (18.7%). We mainly increased the doses of antibiotics 77.4%. The average duration of the treatment was 5.2 ± 3.7 (days). CONCLUSION: The use of antibiotics remains high and uncontrol in intensive care units in Mali, which could be explain by the limited blood culture testing and insufcient of qualied human resource in some of the regional hospitals.