Survey of Antimicrobial Consumption in a University Teaching Hospital in Southern Nigeria

Abstract

Background: There is increasing use of antimicrobial agents worldwide and especially in low- and middle-income countries. Point prevalence studies of antimicrobial consumption can be used to determine intervention areas for antimicrobial stewardship programs. This point prevalence study was conducted in preparation for antimicrobial stewardship program in our hospital. Methods: Data on antimicrobial consumption was collected from patients in the hospital during 4 weeks by hospital doctors. Data was entered into the Global Point Prevalence Survey internet-based application, downloaded, analyzed, and presented in frequencies and percentages. Results: Of 197 patients surveyed across 21 wards, 62.4% had one or more antimicrobial agents. Metronidazole was the most frequently prescribed agent, whereas cephalosporins were the most frequent class prescribed. Community-acquired infection was the most common indication for antimicrobial therapy, whereas skin and soft-tissue infections were the most common diagnosis. Reason for prescription was stated in notes of 61.4% of patients, whereas 34.8% had stop or review dates documented. There was no record of the use of biomarkers to guide antimicrobial treatment. Conclusion: There is a high antimicrobial prevalence in our institution with cephalosporins as the most frequently prescribed class of antimicrobials. Community-acquired infections are the most common indication for an antimicrobial prescription but are surpassed by medical and surgical prophylaxis combined. There is a need for clinicians in this institution to use guidelines and microbiology laboratory reports to guide antimicrobial prescribing to reduce the antimicrobial prevalence among patients.