Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

Bene D. Anand Paramadhas, Celda Tiroyakgosi, Pinkie Mpinda-Joseph, Mathudi Morokotso, Matshediso Matome, Fatima Sinkala, Mavis Gaolebe, Brighid Malone, Emmanuel Molosiwa, Muthu Guhan Shanmugam, Gogaisa Pearl Raseatlholo, Joyce Masilo, Yomi Oyeniran, Stella Marumoloa, Omphile Glory Maakelo, Ishmael Katjakae, Joyce Kgatlwane, Brian Godman*, Amos Massele

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

67 Citations (Scopus)


Objective: There is an urgent need to undertake Point Prevalence Surveys (PPS) across Africa to document antimicrobial utilisation rates given high rates of infectious diseases and growing resistance rates. This is the case in Botswana along with high empiric use and extended prophylaxis to prevent surgical site infections (SSIs) Method: PPS was conducted among all hospital sectors in Botswana using forms based on Global and European PPS studies adapted for Botswana, including rates of HIV, TB, malaria, and malnutrition. Quantitative study to assess the capacity to promote appropriate antibiotic prescribing. Results: 711 patients were enrolled with high antimicrobial use (70.6%) reflecting an appreciable number transferred from other hospitals (42.9%), high HIV rates (40.04% among those with known HIV) and TB (25.4%), and high use of catheters. Most infections were community acquired (61.7%). Cefotaxime and metronidazole were the most prescribed in public hospitals with ceftriaxone the most prescribed antimicrobial in private hospitals. Concerns with missed antibiotic doses (1.96 per patient), high empiric use, extended use to prevent SSIs, high use of IV antibiotics, and variable infrastructures in hospitals to improve future antibiotic use. Conclusion: High antibiotic use reflects high rates of infectious diseases observed in Botswana. A number of concerns have been identified, which are being addressed.

Original languageEnglish
Pages (from-to)535-546
Number of pages12
JournalExpert Review of Anti-Infective Therapy
Issue number7
Publication statusPublished - 3 Jul 2019


  • Antibiotics
  • Botswana
  • antimicrobial resistance
  • antimicrobial stewardship programs
  • antimicrobial utilization
  • drugs and therapeutic committees
  • hospitals
  • point prevalence studies


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