TY - JOUR
T1 - Antimicrobial stewardship capacity and antibiotic utilisation practices in the Cape Coast Teaching Hospital, Ghana
T2 - A point prevalence survey study
AU - Agyare, Elizabeth
AU - Acolatse, Joseph Elikem Efui
AU - Dakorah, Mavis Puopelle
AU - Akafity, George
AU - Chalker, Victoria J.
AU - Spiller, Owen B.
AU - Schneider, Kristan Alexander
AU - Yevutsey, Saviour
AU - Aidoo, Nana Benyin
AU - Blankson, Sophia
AU - Mensah-Acheampong, Frederick
AU - Incoom, Robert
AU - Kurdi, Amanj
AU - Godman, Brian
AU - Ngyedu, Eric Kofi
N1 - Publisher Copyright:
© 2024 Agyare et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2024/1
Y1 - 2024/1
N2 - Introduction Antimicrobial resistance (AMR) is a global threat that necessitates coordinated strategies to improve antibiotic prescribing and reduce AMR. A key activity is ascertaining current prescribing patterns in hospitals to identify targets for quality improvement programmes. Methods The World Health Organisation point prevalence survey methodology was used to assess antibiotic prescribing in the Cape Coast Teaching Hospital. All core variables identified by the methodology were recorded. Results A total of 78.8% (82/104) patients were prescribed at least one antibiotic, with the majority from adult surgical wards (52.14%). Significantly longer hospital stays were associated with patients who underwent surgery (p = 0.0423). "Access"antibiotics dominated total prescriptions (63.8%, 132/207) with ceftriaxone, cefuroxime, and ciprofloxacin being the most prescribed "Watch"antibiotics. The most common indications were for medical prophylaxis (59.8%, 49/82) and surgical prophylaxis (46.3%, 38/82). Over one-third of surgical prophylaxis (34.2%, 13/38) indications extended beyond one day. There was moderate documentation of reasons for antibiotic treatment in patient notes (65.9%, 54/82), and targeted therapy after samples were taken for antimicrobial susceptibility testing (41.7%, 10/24). Guideline compliance was low (25%) where available. Conclusions There was high use of antibiotics within the hospital which needs addressing. Identified quality targets include developing surgical prophylaxis guidelines, reviewing "Watch"antibiotic prescribing, and assessing antibiotic durations for patients on two or more antibiotics. Organizational- level deficiencies were also identified that need addressing to help instigate ASPs. These can be addressed by developing local prescribing protocols and antibiotic stewardship policies in this hospital and wider in Ghana and across Africa.
AB - Introduction Antimicrobial resistance (AMR) is a global threat that necessitates coordinated strategies to improve antibiotic prescribing and reduce AMR. A key activity is ascertaining current prescribing patterns in hospitals to identify targets for quality improvement programmes. Methods The World Health Organisation point prevalence survey methodology was used to assess antibiotic prescribing in the Cape Coast Teaching Hospital. All core variables identified by the methodology were recorded. Results A total of 78.8% (82/104) patients were prescribed at least one antibiotic, with the majority from adult surgical wards (52.14%). Significantly longer hospital stays were associated with patients who underwent surgery (p = 0.0423). "Access"antibiotics dominated total prescriptions (63.8%, 132/207) with ceftriaxone, cefuroxime, and ciprofloxacin being the most prescribed "Watch"antibiotics. The most common indications were for medical prophylaxis (59.8%, 49/82) and surgical prophylaxis (46.3%, 38/82). Over one-third of surgical prophylaxis (34.2%, 13/38) indications extended beyond one day. There was moderate documentation of reasons for antibiotic treatment in patient notes (65.9%, 54/82), and targeted therapy after samples were taken for antimicrobial susceptibility testing (41.7%, 10/24). Guideline compliance was low (25%) where available. Conclusions There was high use of antibiotics within the hospital which needs addressing. Identified quality targets include developing surgical prophylaxis guidelines, reviewing "Watch"antibiotic prescribing, and assessing antibiotic durations for patients on two or more antibiotics. Organizational- level deficiencies were also identified that need addressing to help instigate ASPs. These can be addressed by developing local prescribing protocols and antibiotic stewardship policies in this hospital and wider in Ghana and across Africa.
UR - http://www.scopus.com/inward/record.url?scp=85183499767&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0297626
DO - 10.1371/journal.pone.0297626
M3 - Article
C2 - 38271388
AN - SCOPUS:85183499767
SN - 1932-6203
VL - 19
JO - PLoS ONE
JF - PLoS ONE
IS - 1 January
M1 - e0297626
ER -
