The use of antibiotics in the university hospitals of Conakry: evaluation of the consumption and the analysis of determinants
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20161626Keywords:
Antibiotics, Consumption, Determinants, Conakry, Penicillin’s, HospitalAbstract
Background: The main objectives of this study were to evaluate the use of antibiotics; assess the knowledge and perception of prescribers regarding the use of antibiotics; to describe the policy on the use of antibiotics and to identify factors associated with high antibiotic consumption at the University Hospital of Conakry.
Methods: This study has two components: a retrospective study covering three months' consumption of antibiotics (From January 2013 to March 2013), and a cross-sectional study on both the knowledge and perception of prescribers concerning the use of antibiotics and the policies on their proper use.
Results: Of a total of 1,199 cases examined at the University Hospital of Conakry, 953 patients received at least one antibiotic about 79.5% of the total cases. The total amount consumed was 55.3 DDD / 100 BD. The class of the Extended-spectrum penicillin’s was widely the most used at 22.9 DDD / 100 BD. The median knowledge score of prescribers; valued at a total of 8, was equal to 5. The Composite Index for proper use of Antibiotic (CIATB) was 2.25 / 20. Determinants or factors associated with the large use of antibiotics were the hospital site, the ward and the average length of stay.
Conclusion: Based on the results of our study, it appears that lot antibiotics are largely consumed at the University Hospital of Conakry; and that consumption are influenced by the hospital site, the ward and the length of stay. This study reveals also the absence of any policy of the rational use of antibiotics. Therefore, the study illustrates the need for the implementation of an antimicrobial stewardship action.
References
WHO. Promoting rational use of medicines: core components. WHO policy perspectives on medicines. 2002:005. Available at: http://apps.who.int/medicinedocs/en/d/Jh3011e/. Accessed on 06 April 2016.
WHO. The pursuit of responsible use of medicines: sharing and learning from country experiences, 2012. Available at: http://www.who.int/medicines/areas/rational_use/en/. Accessed on 06 April 2016.
Amadeo B, Dumartin C, Robinson P, Venier A, Parneix P, Gachie J, et al. Easily available adjustment criteria for the comparison of antibiotic consumption in a hospital setting: experience in France. Clin Microbiol Infect. 2010;16(6):735-41.
Patry I, Leroy J, Henon T, Talon D, Hoen B, Bertrand X. Evaluation of antibiotic prescription in a French university hospital. Medecine et maladies infectieuses. 2008;38(7):378-82.
Bassetti M, Di Biagio A, Rebesco B, Amalfitano M, Topal J, Bassetti D. The effect of formulary restriction in the use of antibiotics in an Italian hospital. Eur J Clin Pharmacol. 2001;57(6-7):529-34.
Monnet DL, Archibald LK, Phillips L, Tenover FC, McGowan Jr JE, Gaynes RP. Antimicrobial use and resistance in eight US hospitals: complexities of analysis and modelling. Infect Control Hosp Epidemiol. 1998:388-94.
Goossens H, Ferech M, Stichele RV, Elseviers M. Outpatient antibiotic use in europe and association with resistance: a cross-national database study. The Lancet. 2005;365(9459):579-87.
Hsueh PR, Chen WH, Luh KT. Relationships between antimicrobial use and antimicrobial resistance in Gram-negative bacteria causing nosocomial infections from 1991-2003 at a university hospital in Taiwan. Int J Antimicrob Agents. 2005;26(6):463-72.
Goldmann DA, Huskins WC. Control of nosocomial antimicrobial-resistant bacteria: a strategic priority for hospitals worldwide. Clin Infect Dis. 1997;24(Supplement 1):S139-S45.
Conseil du médicament Quebec. Cadre de référence relatif à l’usage optimal des anti-infectieux et au suivi de l’utilisation de ces médicaments en milieu hospitalier, 2008. Available at: http://www.inesss.qc.ca/fileadmin/doc/CDM/Etudes/CdM-Cadre-antiinfectueux-200810.pdf. Accessed on 06 April 2016.
Hulscher ME, van der Meer JW, Grol RP. Antibiotic use: how to improve it? Int J Med Microbiol. 2010;300(6):351-6.
Evirgen O, Onlen Y, Ertan O. The intensity of antibiotic usage in the university hospital and the investigation of an inappropriate use of antibiotics. Bratislavske lekarske listy. 2010;112(10):595-8.
WHO collaborating centre for drugs statistics methodology: Use of ATC/DDD, 2011. Available at: http://www.whocc.no/use_of_atc_ddd/. Accessed on 06 April 2016.
Palcevski V, Morovic M, Palcevski G. Antibiotic utilization at the university hospital after introducing an antibiotic policy. Eur J Clin Pharmacol. 2000;56(1):97-101.
Kra O, Ehui E, Ouattara B, Tanon A, Bissagnene E, Kadio A. Utilisation des antibiotiques dans les services d'urgence medicale des CHU d'abidjan (cote d'ivoire). Médecine d'Afrique noire. 2006;53(1):55-9.
Thriemer K, Katuala Y, Batoko B, Alworonga JP, Devlieger H, Geet CV, et al. Antibiotic prescribing in DR Congo: a knowledge, attitude and practice survey among medical doctors and students. PloS one. 2013;8(2):e55495.
Ministère des Affaires Sociales. De la Santé et des Droits des femmes, France. Indicateur composite de bon usage des antibiotiques, 2012. Available at: http://social sante.gouv.fr/fichiers/bo/2012/12-08/ste_20120008_0100_0042.pdf. Accessed on 13 April 2016.
Berild D, Ringertz SH, Lelek M. Appropriate antibiotic use according to diagnoses and bacteriological findings: report of 12 point-prevalence studies on antibiotic use in a university hospital. Scand J Infect Dis. 2002;34(1):56-60.
Usluer G, Ozgunes I, Leblebicioglu H. A multicentre point-prevalence study: antimicrobial prescription frequencies in hospitalized patients in Turkey. Annals of clinical microbiology and antimicrobials. 2005;4(1):16.
Porretta A, Giuliani L, Vegni F, Larosa M, Privitera G. Prevalence and patterns of antibiotic prescribing in Italian hospitals. Infection. 2003;31:16-21.
Hu S, Liu X, Peng Y. Assessment of antibiotic prescription in hospitalised patients at a Chinese university hospital. J Infect. 2003;46(3):161-3.
Chukwuani C, Onifade M, Sumonu K. Survey of drug use practices and antibiotic prescribing pattern at a general hospital in Nigeria. Pharmacy world and science. 2002;24(5):188-95.
ECDC/EMEA joint working group. ECDC/ EMEA joint technical report: the bacterial challenge: time to react. Stockholm: european centre for disease prevention and control, 2009. Available at: http://www.ecdc.europa.eu/en/publications/Publications/0909_TER_The_Bacterial_Challenge_Time_to_React.pdf. Accessed on 13 April 2016.
Hadi, U, Keuter M, Van Asten H, Den Broek PV. On behalf of the study group ‘antimicrobial resistance in indonesia: prevalence and prevention.’ AMRIN. 2008;13:888-99.
Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med. 2007;120(9):783-90.
Volluz SD. Quelle est la durée optimale de l'antibiothérapie pour les infections fréquentes? Maladies infectieuses. 2010;266(36):1901-5.
Mettler J, Simcock M, Sendi P, Widmer AF, Bingisser R, Battegay M, et al. Empirical use of antibiotics and adjustment of empirical antibiotic therapies in a university hospital: a prospective observational study. BMC infectious diseases. 2007;7(1):21.
Grand AL, Hogerzeil HV, Haaijer-Ruskamp FM. Intervention research in rational use of drugs: a review. Health policy and planning. 1999;14(2):89-102.
Bosu W, Ofori-Adjei D. Survey of antibiotic prescribing pattern in government health facilities of the wassa west district of Ghana. East African medical journal. 1997;74(3):138-42.
Okeke IN, Lamikanra A, Edelman R. Socioeconomic and behavioral factors leading to acquired bacterial resistance to antibiotics in developing countries. Emerging infectious diseases. 1999;5(1):18.
Guyon AB, Barman A, Ahmed J, Ahmed A, Alam M. A baseline survey on use of drugs at the primary health care level in Bangladesh. Bulletin of the World Health Organization. 1994;72(2):265-72.
Godin G, Bélanger AG, Eccles M, Grimshaw J. Healthcare professionals' intentions and behaviours: A systematic review of studies based on social cognitive theories. Implement Sci. 2008;3(36):1-12.
Amadeo B, Dumartin C, Parneix P, Fourrier-Réglat A, Rogues AM. Relationship between antibiotic consumption and antibiotic policy: an adjusted analysis in the french healthcare system. J Antimicrob Chemother. 2010:dkq456.
