ABSTRACT

Objectives

The understanding of antimicrobial utilization patterns is pertinent to successful implementation of the National Action Plans on Antimicrobial Resistance (AMR). There is, however, limited information on antibiotics utilization in Nigeria. This study was undertaken to build on existing information and provide direction for appropriate interventions including Antibiotics Stewardship Programs (ASP).

Method

A Point Prevalence Study (PPS) was conducted in two public urban health facilities in Lagos, Nigeria using a design adapted from the European Center for Disease Prevention and Control (ECDC) and Global-PPS surveys.

Results

The prevalence of antibiotics use was 80.6% administered mostly parenterally (83.1% of total prescriptions) with concerns with extended surgical antibiotics prophylaxis. The mostly used antibiotics in the secondary hospital were parenteral metronidazole (32.4%), ceftriaxone (27.5%), and amoxicillin + clavulanate (8.2%) while the mostly used in the tertiary hospital were ceftriaxone (25.3%), parenteral metronidazole (19.1%), and amoxicillin + clavulanate (9.3%). There was an appreciable lack of specific functional capacities, policies, and processes to promote appropriate antimicrobial use in both hospitals.

Conclusions

There is high rate of antibiotics utilization in these facilities with lack of institutional frameworks and processes for ensuring appropriate antibiotic use. The study provides the information needed to improve future antimicrobial use in hospitals and reduce AMR.

中文翻译：

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尼日利亚城市二级和三级医疗机构住院患者抗生素使用的多中心流行率研究：结果和意义

摘要

目标

对抗菌素使用模式的理解与成功实施抗菌素耐药性国家行动计划 (AMR) 息息相关。然而，关于尼日利亚抗生素使用的信息有限。这项研究是在现有信息的基础上进行的，并为包括抗生素管理计划 (ASP) 在内的适当干预措施提供指导。

方法

在尼日利亚拉各斯的两个公共城市卫生设施中进行了点流行率研究 (PPS)，其设计改编自欧洲疾病预防和控制中心 (ECDC) 和 Global-PPS 调查。

结果

抗生素使用的流行率为 80.6%，主要是肠外给药（占总处方的 83.1%），担心延长手术抗生素预防。二级医院使用最多的抗生素是注射用甲硝唑（32.4%）、头孢曲松（27.5%）、阿莫西林+克拉​​维酸（8.2%），三级医院使用最多的是头孢曲松（25.3%）、注射用甲硝唑（19.1%） ) 和阿莫西林 + 克拉维酸 (9.3%)。两家医院都明显缺乏促进适当使用抗菌药物的具体职能能力、政策和流程。

结论

这些设施的抗生素使用率很高，缺乏确保适当使用抗生素的制度框架和流程。该研究提供了改善医院未来抗菌药物使用和降低 AMR 所需的信息。