دورية أكاديمية
أعرض في EDS

Antibiotic use and resistance patterns at Rumphi District Hospital in Malawi: a cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Antibiotic use and resistance patterns at Rumphi District Hospital in Malawi: a cross-sectional study.
المؤلفون: Mithi B; School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi. branytitus@gmail.com.; Ministry of Health, Rumphi District Hospital, Rumphi, Malawi. branytitus@gmail.com., Luhanga M; Ministry of Health, Rumphi District Hospital, Rumphi, Malawi., Kaminyoghe F; Pharmaceutical Society of Malawi (PHASOM), Lilongwe, Malawi., Chiumia F; Department of Pharmacy, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi., Banda DL; Department of Medical Laboratory Sciences, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi., Nyama L; Ministry of Health, Rumphi District Hospital, Rumphi, Malawi.
المصدر: BMC infectious diseases [BMC Infect Dis] 2024 Apr 26; Vol. 24 (1), pp. 445. Date of Electronic Publication: 2024 Apr 26.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Anti-Bacterial Agents*/therapeutic use , Anti-Bacterial Agents*/pharmacology , Hospitals, District* , Microbial Sensitivity Tests*, Humans ; Cross-Sectional Studies ; Malawi/epidemiology ; Female ; Male ; Adult ; Middle Aged ; Retrospective Studies ; Young Adult ; Drug Resistance, Bacterial ; Adolescent ; Aged
مستخلص: Background: Overuse of antibiotics is a key driver of antimicrobial resistance (AMR) world-wide. Malawi continues to report rising cases of AMR among both in-patients and out-patients. We investigated antibiotic use and resistance patterns among patients with suspected first line antibiotic treatment failure at Rumphi District Hospital, Malawi.
Methods: We used a cross-sectional study design in which records of patients data on culture and antimicrobial sensitivity tests were extracted, alongside treatment history from 2019 to March, 2023, retrospectively. We also included findings for point prevalence survey (PPS) conducted within four hospital wards in June, 2022 by a well-trained multi-disciplinary team from within the hospital. The data was analyzed for antibiotic use, characterization of pathogens and their susceptibility patterns using Microsoft excel and STATA-14 software.
Results: A total of 85 patients' data records were reviewed on antibiotics resistance pattern in which 54 (63.5%) were females. Patient antibiotic history captured indicated Metronidazole (23%), Gentamycin (20%) and Doxycycline (23%) as the most frequently used antibiotics among clients referred for microbiological investigations. Among locally available antibiotics with over 50% sensitivity were Chloramphenicol (61%), ciprofloxacin (55%), and ceftriaxone (54%). Penicillins were among antibiotics with highest resistance: ampicillin (100%), amoxyclav (90%), Piperacilin-tazobactam (63%). The majority of patients came from STI clinic and presented with genital discharges 44% (n = 39). Over 80% of the isolated N. gonorrhoeae exhibited a reduced susceptibility to gentamycin. Prevalence of Methicillin resistant staphylococcus Aureus (MRSA) was 46% and were mostly isolated from wound pus. Among 80 data records of the patients reviewed during PPS, Ceftriaxone (54.3%) and Metronidazole (23.3%) emerged as the most frequently used antibiotics in the wards which were prescribed empirically without a microbiological indication.
Conclusion: In this study setting, we observed high use of watch antibiotics along with problem of multi-drug resistant infections in patients experiencing clinical failure in a variety of clinical syndromes. The findings underline the need to revamp diagnostic microbiology to increase the uptake of antimicrobial susceptibility testing to guide specific prescriptions of broad-spectrum antibiotics in the watch list.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Antibiotic resistance; Malawi; Multi-drug resistance; Point Prevalence Survey
المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20240426 Date Completed: 20240427 Latest Revision: 20240429
رمز التحديث: 20240429
مُعرف محوري في PubMed: PMC11046875
DOI: 10.1186/s12879-024-09333-w
PMID: 38671359
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2334
DOI:10.1186/s12879-024-09333-w