Labi Appiah-Korang, Obeng-Nkrumah Noah, Dayie Nicholas T K D, Egyir Beverly, Sampane-Donkor Eric, Newman Mercy Jemima, Opintan Japheth Awuletey
Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
JAC Antimicrob Resist. 2021 Jul 12;3(3):dlab087. doi: 10.1093/jacamr/dlab087. eCollection 2021 Sep.
Antimicrobial resistance (AMR) is a public health crisis of global proportions. Data is required to understand the local drivers of antimicrobial resistance and support decision-making processes including implementation of appropriate antimicrobial stewardship strategies.
To measure antimicrobial usage in hospitals in Ghana.
Using the Global Point Prevalence instruments and processes, we conducted point prevalence surveys across AMR surveillance sentinel hospitals in Ghana, between September and December 2019. Hospital records of all inpatients on admission at 0800 hours on a specific day were reviewed for antimicrobial use at the time of the survey. Data on antibiotic use, including indication for use and quality of prescribing were recorded.
Overall prevalence of antibiotic use across the sentinel sites was 54.9% (1591/2897), ranging between 48.4% (266/550) and 67.2% (82/122). The highest prevalence of antibiotic use 89.3% (25/28) was observed in adult ICUs. The average number of antibiotics prescribed per patient was 1.7 (1562/2620), with the majority (66%, 728/2620) administered via the parenteral route. The five most-commonly used antibiotics were metronidazole (20.6%, 541/2620), cefuroxime (12.9%, 338/2620), ceftriaxone (11.8%, 310/2620), amoxicillin/clavulanic acid (8.8%, 231/2620) and ciprofloxacin (7.8%, 204/2620). The majority (52.2%; 1367/2620) of antibiotics were prescribed to treat an infection, whilst surgical prophylaxis accounted for 26.1% (684/2620).
We observed a high use of antibiotics including metronidazole and cephalosporins at the participating hospitals. Most antibiotics were empirically prescribed, with low use of microbiological cultures. High usage of third-generation cephalosporins especially for community-acquired infections offers an opportunity for antibiotic stewardship interventions.
抗菌药物耐药性（AMR）是一个全球性的公共卫生危机。需要数据来了解抗菌药物耐药性的当地驱动因素，并支持包括实施适当抗菌药物管理策略在内的决策过程。
测量加纳医院的抗菌药物使用情况。
我们使用全球现患率调查工具和流程，于2019年9月至12月期间，在加纳的抗菌药物耐药性监测定点医院开展了现患率调查。回顾了特定日期上午08:00入院的所有住院患者的医院记录，以了解调查时的抗菌药物使用情况。记录了抗生素使用数据，包括使用指征和处方质量。
各定点医院的抗生素总体使用率为54.9%（1591/2897），范围在48.4%（266/550）至67.2%（82/122）之间。成人重症监护病房的抗生素使用率最高，为89.3%（25/28）。每位患者使用的抗生素平均数量为1.7种（1562/2620），大多数（66%，728/2620）通过肠胃外途径给药。最常用的五种抗生素为甲硝唑（20.6%，541/2620）、头孢呋辛（12.9%，338/2620）、头孢曲松（11.8%，310/2620）、阿莫西林/克拉维酸（8.8%，231/2620）和环丙沙星（7.8%，204/2620）。大多数（52.2%；1367/2620）抗生素用于治疗感染，而手术预防占26.1%（684/2620）。
我们观察到参与调查的医院中抗生素使用量较高，包括甲硝唑和头孢菌素。大多数抗生素是经验性处方，微生物培养的使用较少。第三代头孢菌素的高使用率，尤其是用于社区获得性感染，为抗菌药物管理干预提供了机会。
