Background: Excessive use of ceftriaxone contributes to the emergence and spread of antimicrobial resistance (AMR). In low and middle-income countries, antibiotics are overused but data on consumption are scarcely available. We aimed to determine the prevalence and factors influencing ceftriaxone prescription in a tertiary care private not-for-profit hospital in Uganda. Methods: A cross-sectional study was carried out from October 2019 through May 2020 at Mengo Hospital in Uganda. Patients admitted to the medical ward and who had been prescribed antibiotics were enrolled. Sociodemographic and clinical data were recorded in a structured questionnaire. Bivariate and adjusted logistic regression analyses were performed to determine factors associated with ceftriaxone prescription. Results: Study participants were mostly female (54.7%). The mean age was 56.2 years (SD: 21.42). The majority (187, 73.3%) presented with fever. Out of the 255 participants included in this study, 129 (50.6%) participants were prescribed ceftriaxone. Sixty-five (25.5%) and forty-one (16.0%) participants had a prescription of levofloxacin and metronidazole, respectively. Seven participants (2.7%) had a prescription of meropenem. Out of 129 ceftriaxone prescriptions, 31 (24.0%) were in combination with other antibiotics. Overall, broad-spectrum antibiotic prescriptions accounted for 216 (84.7%) of all prescriptions. Ceftriaxone was commonly prescribed for pneumonia (40/129, 31%) and sepsis (38/129, 29.5%). Dysuria [OR = 0.233, 95% CI (0.07–0.77), p = 0.017] and prophylactic indication [OR = 7.171, 95% CI (1.36–37.83), p = 0.020] were significantly associated with ceftriaxone prescription. Conclusions: Overall, we observed a high prevalence of prescriptions of ceftriaxone at the medical ward of Mengo Hospital. We recommend an antibiotic stewardship program (ASP) to monitor antibiotic prescription and sensitivity patterns in a bid to curb AMR.

中文翻译：

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乌干达一家三级医疗私立非营利医院抗生素流行率研究及影响 WHO 观察类抗生素头孢曲松处方的因素

背景：过度使用头孢曲松会导致抗菌素耐药性 (AMR) 的出现和传播。在低收入和中等收入国家，抗生素被过度使用，但几乎没有关于消费的数据。我们旨在确定乌干达一家三级医疗私立非营利医院中头孢曲松处方的患病率和影响因素。方法：一项横断面研究于 2019 年 10 月至 2020 年 5 月在乌干达 Mengo 医院进行。入组内科病房并开具抗生素处方的患者。社会人口学和临床数据记录在结构化问卷中。进行双变量和调整逻辑回归分析以确定与头孢曲松处方相关的因素。结果：研究参与者主要是女性（54.7%）。平均年龄为 56.2 岁（标准差：21.42）。大多数 (187, 73.3%) 出现发烧。在本研究中包括的 255 名参与者中，129 名（50.6%）参与者服用了头孢曲松。65 名 (25.5%) 和 41 名 (16.0%) 参与者分别开具了左氧氟沙星和甲硝唑的处方。7 名参与者 (2.7%) 开了美罗培南处方。在 129 份头孢曲松处方中，31 份（24.0%）与其他抗生素联合使用。总体而言，广谱抗生素处方占所有处方的 216 份（84.7%）。头孢曲松通常用于治疗肺炎 (40/129, 31%) 和败血症 (38/129, 29.5%)。排尿困难 [OR = 0.233, 95% CI (0.07–0.77), p= 0.017] 和预防适应症 [OR = 7.171, 95% CI (1.36–37.83), p = 0.020] 与头孢曲松处方显着相关。结论：总体而言，我们观察到 Mengo 医院内科病房的头孢曲松处方率很高。我们建议通过抗生素管理计划 (ASP) 来监控抗生素处方和敏感性模式，以遏制 AMR。