TY - JOUR
T1 - A national, multicentre, web-based point prevalence survey of antimicrobial use and quality indices among hospitalised paediatric patients across South Africa
AU - Skosana, P. P.
AU - Schellack, N.
AU - Godman, B.
AU - Kurdi, A.
AU - Bennie, M.
AU - Kruger, D.
AU - Meyer, J. C.
N1 - Funding Information:
This study was funded by an ENAABLERS grant and as part of a Newton Scholarship awarded to NS (Sefako Makgatho University), jointly funded by the South African Medical Research Council and UK Medical Research Council. The authors had full access to all the data and final responsibility for the decision to submit the paper for publication.
Funding Information:
The authors gratefully acknowledge Ms Petra Gaylard, a consultation statistician, for statistical analysis of the data. The authors also thank all of the Departments of Health in the provinces and the hospital management of the participating hospitals for allowing us to collect data. In addition, the authors thank the MPharm pharmacist interns and support staff for all their help with data collection. This study was funded by an ENAABLERS grant and as part of a Newton Scholarship awarded to NS (Sefako Makgatho University), jointly funded by the South African Medical Research Council and UK Medical Research Council. The authors had full access to all the data and final responsibility for the decision to submit the paper for publication. None declared. Ethical approval for the study was obtained from the Sefako Makgatho University Research and Ethics Committee (SMUREC) [SMUREC/P/36/2018: PG] after review and recommendation by the School of Pharmacy Research Committee. The umbrella study (ENAABLERS) has also been approved by SMUREC [SMUREC/P/233/2017]. The National Department of Health and the provincial departments were consulted for permission to conduct the study in the different public health centres. Permission to conduct the study was sought from the Chief Executive Officers of each of the selected hospitals participating in the study.
Publisher Copyright:
© 2021 The Author(s)
PY - 2022/6
Y1 - 2022/6
N2 - Objectives: Data on antimicrobial consumption among the paediatric population in public hospitals in South Africa are limited. This needs to be addressed to improve future antimicrobial use and reduce antimicrobial resistance rates. This study aimed to quantify antimicrobial usage and to identify and classify which antimicrobials are used in the paediatric population in public sector hospitals in South Africa according to the World Health Organization (WHO) AWaRe list of antimicrobials. Methods: A point prevalence survey was conducted among 18 public sector hospitals from nine provinces using a newly developed web-based application. Data were analysed according to the WHO AWaRe list to guide future quality improvement programmes. Results: A total of 1261 paediatric patient files were reviewed, with 49.7% (627/1261) receiving at least one antimicrobial and with 1013 antimicrobial prescriptions overall. The top five antimicrobials included ampicillin (16.4%), gentamicin (10.0%), amoxicillin/enzyme inhibitor (9.6%), ceftriaxone (7.4%) and amikacin (6.3%). Antimicrobials from the ‘Access’ classification were the most used (55.9%), with only 3.1% being from the ‘Reserve’ classification. The most common infectious conditions for which an antimicrobial was prescribed were pneumonia (14.6%; 148/1013) and clinical sepsis (11.0%; 111/1013). Parenteral administration (75.6%; 766/1013) and prolonged surgical prophylaxis (66.7%; 10/15) were common concerns. Only 28.0% (284/1013) of prescribed antimicrobials had cultures requested; of which only 38.7% (110/284) of culture results were available in the files. Conclusion: Overall, antimicrobial prescribing is common among paediatric patients in South Africa. Interventions should be targeted at improving antimicrobial prescribing, including surgical prophylaxis, and encouraging greater use of oral antibiotics.
AB - Objectives: Data on antimicrobial consumption among the paediatric population in public hospitals in South Africa are limited. This needs to be addressed to improve future antimicrobial use and reduce antimicrobial resistance rates. This study aimed to quantify antimicrobial usage and to identify and classify which antimicrobials are used in the paediatric population in public sector hospitals in South Africa according to the World Health Organization (WHO) AWaRe list of antimicrobials. Methods: A point prevalence survey was conducted among 18 public sector hospitals from nine provinces using a newly developed web-based application. Data were analysed according to the WHO AWaRe list to guide future quality improvement programmes. Results: A total of 1261 paediatric patient files were reviewed, with 49.7% (627/1261) receiving at least one antimicrobial and with 1013 antimicrobial prescriptions overall. The top five antimicrobials included ampicillin (16.4%), gentamicin (10.0%), amoxicillin/enzyme inhibitor (9.6%), ceftriaxone (7.4%) and amikacin (6.3%). Antimicrobials from the ‘Access’ classification were the most used (55.9%), with only 3.1% being from the ‘Reserve’ classification. The most common infectious conditions for which an antimicrobial was prescribed were pneumonia (14.6%; 148/1013) and clinical sepsis (11.0%; 111/1013). Parenteral administration (75.6%; 766/1013) and prolonged surgical prophylaxis (66.7%; 10/15) were common concerns. Only 28.0% (284/1013) of prescribed antimicrobials had cultures requested; of which only 38.7% (110/284) of culture results were available in the files. Conclusion: Overall, antimicrobial prescribing is common among paediatric patients in South Africa. Interventions should be targeted at improving antimicrobial prescribing, including surgical prophylaxis, and encouraging greater use of oral antibiotics.
KW - AWaRe list of antimicrobials
KW - Antibiotics
KW - Antimicrobial consumption
KW - Paediatric
KW - Point prevalence survey
KW - South Africa
UR - http://www.scopus.com/inward/record.url?scp=85122614865&partnerID=8YFLogxK
U2 - 10.1016/j.jgar.2021.12.003
DO - 10.1016/j.jgar.2021.12.003
M3 - Article
C2 - 34915203
AN - SCOPUS:85122614865
SN - 2213-7165
VL - 29
SP - 542
EP - 550
JO - Journal of Global Antimicrobial Resistance
JF - Journal of Global Antimicrobial Resistance
ER -