Merga Kassa Haile, Getachew Edlawit Mesfin, Fujita Ayako Wendy, Abayneh Mahlet, Jacob Jesse T, Ali Solomon, Melesse Hayat Oumer, Babiker Ahmed, Getachew Liya Sisay, Hailu Tsegaye, Mohammed Jemal, Solomon Bethelhem, Rebolledo Paulina A, Abdissa Alemseged, Kempker Russell R
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, USA.
Antimicrob Steward Healthc Epidemiol. 2024 Oct 18;4(1):e180. doi: 10.1017/ash.2024.432. eCollection 2024.
Antimicrobial resistance (AMR) renders many bacterial infections untreatable and results in substantial morbidity and mortality worldwide. Understanding antibiotic use in clinical settings including hospitals is critical to optimize antibiotic use and prevent resistance.
Hospital antibiotic point prevalence survey (PPS).
The study was conducted in two large, teaching hospitals in Addis Ababa, Ethiopia. We performed two survey rounds in December 2021 and January 2022 through real-time chart review using the World Health Organization PPS methodology. Data were collected using a web-based database, and descriptive statistics were performed to analyze antibiotic use by various characteristics.
Among 1020 hospitalized patients, 318 (32%) were ≤14 years and 370 (36%) had surgery during the current hospitalization. A total of 662 (65%) were receiving an antibiotic on the day of survey and 346 (39%) were receiving ≥2 antibiotics. A community-acquired infection (43%) was the most common indication for an antibiotic followed by surgical prophylaxis (27%) and hospital-acquired infection (23%). Antibiotic use was highest among those ≤24 months in age and among patients in trauma, surgical, and pediatric wards. Cephalosporin (42%) and penicillin (16%) antibiotics were the most frequently prescribed classes. Only 11% of patients on antibiotics had samples collected for microbiological testing; hence, almost all antibiotic therapy was empiric.
Despite global and national efforts to improve antimicrobial stewardship, antibiotic use remains high in urban teaching hospitals in Ethiopia. Implementation of antimicrobial stewardship activities and microbiology utilization are needed to guide antimicrobial selection and curtail antibiotic overuse.
抗菌药物耐药性（AMR）使许多细菌感染无法得到治疗，并在全球范围内导致大量发病和死亡。了解包括医院在内的临床环境中的抗生素使用情况对于优化抗生素使用和预防耐药性至关重要。
医院抗生素现患率调查（PPS）。
该研究在埃塞俄比亚亚的斯亚贝巴的两家大型教学医院进行。我们于2021年12月和2022年1月通过使用世界卫生组织PPS方法进行实时病历审查开展了两轮调查。使用基于网络的数据库收集数据，并进行描述性统计以按各种特征分析抗生素使用情况。
在1020名住院患者中，318名（32%）年龄≤14岁，370名（36%）在本次住院期间接受了手术。共有662名（65%）在调查当天正在接受抗生素治疗，346名（39%）正在接受≥2种抗生素治疗。社区获得性感染（43%）是使用抗生素最常见的指征，其次是手术预防（27%）和医院获得性感染（23%）。抗生素使用在年龄≤24个月的患者以及创伤、外科和儿科病房的患者中最高。头孢菌素类抗生素（42%）和青霉素类抗生素（16%）是最常开具的类别。接受抗生素治疗的患者中只有11%采集了样本进行微生物检测；因此，几乎所有抗生素治疗都是经验性的。
尽管全球和国家都在努力改善抗菌药物管理，但埃塞俄比亚城市教学医院的抗生素使用仍然很高。需要开展抗菌药物管理活动并利用微生物学来指导抗菌药物选择并减少抗生素过度使用。
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