摘要
Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.
Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.
作者
Steward Mudenda
Mary Chomba
Billy Chabalenge
Christabel Nang’andu Hikaambo
Michelo Banda
Victor Daka
Annie Zulu
Abraham Mukesela
Maxwell Kasonde
Peter Lukonde
Enock Chikatula
Lloyd Matowe
Ronald Kampamba Mutati
Tyson Lungwani Muungo
Tobela Mudenda
Shafiq Mohamed
Scott Matafwali
Steward Mudenda;Mary Chomba;Billy Chabalenge;Christabel Nang’andu Hikaambo;Michelo Banda;Victor Daka;Annie Zulu;Abraham Mukesela;Maxwell Kasonde;Peter Lukonde;Enock Chikatula;Lloyd Matowe;Ronald Kampamba Mutati;Tyson Lungwani Muungo;Tobela Mudenda;Shafiq Mohamed;Scott Matafwali(Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia;Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka, Zambia;Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia;Bell Pharmacy, Kabulonga Centro Mall, Lusaka, Zambia;Ministry of Health Headquarters, Ndeke House, Lusaka, Zambia;Department of Pharmacy, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia;Faculty of Pharmacy, School of Pharmacy, Eden University, Lusaka, Zambia;Department of Pathology, Ndola Teaching Hospital, Ndola, Zambia;Remedium Pharmaceuticals Limited, Lusaka, Zambia;Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK)
