WHO-Point prevalence survey of antibiotic use in a Senegalese tertiary care hospital.

The inappropriate use of antibiotics in human medicine is one of the primary causes of antimicrobial resistance. The objective of this study was to estimate the prevalence of antibiotic use at Dakar Principal Hospital and to identify factors associated with the prescription of broad-spectrum antibiotics. This cross-sectional study, conducted according to the WHO-point prevalence survey method, included all patients hospitalized in acute care wards who presented at 8:00 AM on the day of the survey. Data were collected from 9 to 29 December 2024 on working days. Multivariate logistic regression was performed to identify factors associated with the prescription of broad-spectrum antibiotics. A total of 222 patients, predominantly male (sex ratio = 1.26), were included. The median age of patients over 2 years was 45 years (interquartile range: 29-64 years). In total, 158 antibiotic prescriptions were reported for 101 included patients, resulting in a prevalence of 45.5% (101/222) and a prescription ratio of 1.56 antibiotics per patient. The most commonly prescribed antibiotics were amoxicillin-clavulanic acid (n = 36; 16.2%), followed by ceftriaxone (n = 21; 9.5%). Community acquired infection was the most common reason for prescription (n = 86; 54.4%), and 98 prescriptions (62%) were in compliance with the local guidelines. Antibiotics from the watch group of the AWaRe classification were used in 55 patients (54.4%). According to the multivariate analysis, the presence of a healthcare-associated infection was associated with this use (OR = 12.1; 95% CI [2.62-93.7]). These antibiotics from the watch group were significantly less commonly prescribed for surgical prophylaxis (OR = 0.13; 95% CI [0.02 - 0.63]). The prevalence of antibiotic use was high in the studied facility, with more prescriptions belonging to the watch group. These results underscore the need to strengthen antimicrobial stewardship policies.