Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic : findings and implications
Mudenda, Steward and Chilimboyi, Robert and Kemgne, Loriane Arielle Mobou and Mweetwa, Larry and Matafwali, Scott and Daka, Victor and Mfune, Ruth Lindizyani and Bumbangi, Flavien Nsoni and Hangoma, Jimmy and Chabalenge, Billy and Godman, Brian (2024) Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic : findings and implications. JAC-Antimicrobial Resistance, 6 (1). dlae023. ISSN 2632-1823 (https://doi.org/10.1093/jacamr/dlae023)
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Abstract
Background: Antimicrobial resistance (AMR) is a global public health problem that is fuelled by the inappropriate prescribing of antibiotics, especially those from the ‘watch’ and ‘reserve’ antibiotic lists. The irrational prescribing of antibiotics is particularly prevalent in developing countries, including Zambia. Consequently, there is a need to better understand prescribing patterns across sectors in Zambia as a basis for future interventions. This study evaluated the prescribing patterns of antibiotics using the WHO prescribing indicators alongside the ‘access, watch and reserve’ (AWaRe) classification system post-COVID pandemic at a faith-based hospital in Zambia. Methods: A cross-sectional study was conducted from August 2023 to October 2023 involving the review of medical records at St. Francis’ Mission Hospital in Zambia. A WHO-validated tool was used to evaluate antibiotic prescribing patterns alongside the AWaRe classification tool. Results: Out of 800 medical records reviewed, 2003 medicines were prescribed. Each patient received an average of 2.5 medicines per prescription. Antibiotics were prescribed in 72.3% of encounters, of which 28.4% were injectable. The most frequently prescribed antibiotics were amoxicillin (23.4%—access), metronidazole (17.1%—access), ciprofloxacin (8%—watch) and ceftriaxone (7.4%—watch), with 77.1% overall from the ‘access’ list. Encouragingly, 96.5% of the medicines were prescribed by their generic names and 98% were from the Zambia Essential Medicines List. Conclusions: There were high rates of antibiotic prescribing, including injectable antibiotics, which needs addressing going forward. It is crucial to implement targeted measures, including antimicrobial stewardship programmes, to improve future antibiotic prescribing in Zambia and reduce the risk of AMR.
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Item type: Article ID code: 88099 Dates: DateEvent22 February 2024Published6 February 2024AcceptedSubjects: Medicine > Public aspects of medicine Department: Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences Depositing user: Pure Administrator Date deposited: 06 Feb 2024 15:25 Last modified: 16 Nov 2024 23:43 Related URLs: URI: https://strathprints.strath.ac.uk/id/eprint/88099