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

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 in patients receiving an 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 recefuroxime ( 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 very high antimicrobial prescribing rates in the hospital and the need to assess its 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.