Emergency medicine division, University of Kwazulu-Natal Republic of South Africa.
Afr Health Sci. 2021 Dec;21(4):1651-1661. doi: 10.4314/ahs.v21i4.19.
Antibiotic resistance is a major public health concern. The Emergency department (ED) is the community gate for healthcare where antibiotics are often prescribed. However, there is a paucity of data regarding antibiotic prescription practices in Africa.
To describe the use of antibiotics in an ED and level of prescribing adherence to national guidelines.
Retrospective observational study of antibiotic practice in ED. All patients who presented to ED during the study period and were prescribed an anti-microbial agent were included. Data on demographics, working diagnosis, anti-microbial prescribed, dose, route and prescriber level were used to provide descriptive statistics of these parameters.
We identified 195 (13.4%) patients who received anti-microbial therapy among 1454 charts reviewed. The mean age was 34.8 with male predominance. The most common indication identified was abscess in 37 (30.8%) patients and in general surgical conditions had the highest rate of antimicrobials prescribed at 54.3%. In addition, co-amoxiclav was the most commonly prescribed anti-microbial (72.15%). We found that combination therapy was not common practice in ED, with majority of the patients having received single anti-microbial therapy (87.18%). The appropriateness of antimicrobial prescriptions was (46.2%) and not statistically significant (P = 0.654).
The most commonly prescribed anti-microbial was co amoxiclav and the most common indication was abscess. It was found that antibiotic prescription appropriateness was acceptable when compared to studies conducted in developed countries. However, further research within other hospital departments will add to the study to determine the adherence as an institution rather than the Emergency department alone, as antimicrobial resistance is a major global healthcare problem and impacts patient care throughout the care pathway.
抗生素耐药性是一个主要的公共卫生关注点。急诊科是社区医疗的门户，经常开具抗生素。然而，关于非洲抗生素处方实践的数据很少。
描述急诊科抗生素的使用情况以及处方遵循国家指南的程度。
对急诊科抗生素实践进行回顾性观察研究。纳入研究期间在急诊科就诊并开具抗菌药物的所有患者。使用人口统计学、工作诊断、开处方的抗菌药物、剂量、途径和处方者级别等数据，提供这些参数的描述性统计数据。
我们在审查的 1454 份图表中确定了 195 名（13.4%）接受抗生素治疗的患者。平均年龄为 34.8 岁，男性居多。确定的最常见指征是 37 名（30.8%）患者的脓肿，一般外科条件下开具抗生素的比例最高，为 54.3%。此外，复方阿莫西林是最常用的抗生素（72.15%）。我们发现，联合治疗并非急诊科的常见做法，大多数患者接受单一抗生素治疗（87.18%）。抗生素处方的适当性为（46.2%），但无统计学意义（P=0.654）。
最常开的抗生素是复方阿莫西林，最常见的指征是脓肿。与在发达国家进行的研究相比，抗生素处方的适当性可以接受。然而，在其他医院科室进行进一步研究将有助于确定作为一个机构而非仅急诊科的遵循情况，因为抗生素耐药性是一个主要的全球医疗保健问题，影响整个护理路径的患者护理。
