The global point prevalence survey of antimicrobial consumption and resistance (Global-PPS): First results of antimicrobial prescribing in a children hospital in Nigeria

Abstract

Abstract: Background: Antimicrobial stewardship is vital for our hospital practice but it requires a knowledge of antibiotic prescribing practices, which is currently lacking. This survey aimed to assess the antimicrobial prescribing practices in our hospital.

Method: To obtain baseline information on antimicrobial prescribing practices, a uniform and standardized method for surveillance of antibiotic use in hospitals was employed. A point prevalence survey (PPS) was conducted in all the wards of the Massey Street Children’s hospital in June 2019. The PPS included all i n p a t i e n t s r e c e i v i n g a n
antimicrobial on the day of survey. Data collected included age, gender, antimicrobial agents, microbiological data, and compliance to guidelines, documentation of reasons and stop/ review date of prescription. The denominator was the number of eligible patients. A web-based application developed by the University of Antwerp was used for data-entry, validation and reporting.

Results: Sixty-seven children were eligible, of which 62 (92%) CC –BY 4.0 received 128 antimicrobials. Fifty- seven (85%) were on multiple antimicrobial therapies, and route of administration was parenteral in 86%. All prescriptions were empiric. Reasons for prescribing were documented in 121(94.5%) therapies in case notes; Stop/review dates were not documented in 126(98.4%). The most frequently prescribed antibiotics we r e c e f u r o x i m e ( 1 8 % ) ,
Ampicillin-sulbactam (15%) and gentamicin (12%). Antibiotic  guidelines were not available. Most common diagnoses were sepsis (42%), pneumonia (15%) and malaria (9%).

Conclusion: This survey revealed v e r y h i g h a n t i m i c r o b i a l prescribing rates in the hospital and the need to assess it appropriateness. We disclosed areas to improve antibiotic prescribing: antibiotic prescribing according to guidelines and low reporting of a stop/review date. There is a need to create awareness for evidence based antibiotic guidelines.

Keywords: Antimicrobial, Stewardship, Resistance, Children, Global-PPS