Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies
<h3>Background</h3><p dir="ltr">There is paucity of data describing the rate and quality indices of antibiotics used among hospitalized patients at continental level in Africa. This systematic review evaluated the pooled prevalence, indications, and types of antibiotics u...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | |
| منشور في: |
2023
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| الموضوعات: | |
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إضافة وسم
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| _version_ | 1864513530508607488 |
|---|---|
| author | Usman Abubakar (6433472) |
| author2 | Muhammad Salman (799405) |
| author2_role | author |
| author_facet | Usman Abubakar (6433472) Muhammad Salman (799405) |
| author_role | author |
| dc.creator.none.fl_str_mv | Usman Abubakar (6433472) Muhammad Salman (799405) |
| dc.date.none.fl_str_mv | 2023-05-08T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1007/s40615-023-01610-9 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Antibiotic_Use_Among_Hospitalized_Patients_in_Africa_A_Systematic_Review_of_Point_Prevalence_Studies/24999089 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Epidemiology Health services and systems Public health Point prevalence Africa Antibiotic prescribing Antibiotic use Hospitalized patients Systematic review |
| dc.title.none.fl_str_mv | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">There is paucity of data describing the rate and quality indices of antibiotics used among hospitalized patients at continental level in Africa. This systematic review evaluated the pooled prevalence, indications, and types of antibiotics used in hospitals across Africa.</p><h3>Methods</h3><p dir="ltr">Three electronic databases, PubMed, Scopus, and African Journals Online (AJOL), were searched using search terms. Point prevalence studies of antibiotic use in inpatient settings published in English language from January 2010 to November 2022 were considered for selection. Additional articles were identified by checking the reference list of selected articles.</p><h3>Results</h3><p dir="ltr">Of the 7254 articles identified from the databases, 28 eligible articles involving 28 studies were selected. Most of the studies were from Nigeria (n = 9), Ghana (n = 6), and Kenya (n = 4). Overall, the prevalence of antibiotic use among hospitalized patients ranged from 27.6 to 83.5% with higher prevalence in West Africa (51.4–83.5%) and North Africa (79.1%) compared to East Africa (27.6–73.7%) and South Africa (33.6–49.7%). The ICU (64.4–100%; n = 9 studies) and the pediatric medical ward (10.6–94.6%; n = 13 studies) had the highest prevalence of antibiotic use. Community-acquired infections (27.7–61.0%; n = 19 studies) and surgical antibiotic prophylaxis (SAP) (14.6–45.3%; n = 17 studies) were the most common indications for antibiotic use. The duration of SAP was more than 1 day in 66.7 to 100% of the cases. The most commonly prescribed antibiotics included ceftriaxone (7.4–51.7%; n = 14 studies), metronidazole (14.6–44.8%; n = 12 studies), gentamicin (n = 8 studies; range: 6.6–22.3%), and ampicillin (n = 6 studies; range: 6.0–29.2%). The access, watch, and reserved group of antibiotics accounted for 46.3–97.9%, 1.8–53.5%, and 0.0–5.0% of antibiotic prescriptions, respectively. The documentation of the reason for antibiotic prescription and date for stop/review ranged from 37.3 to 100% and 19.6 to 100%, respectively.</p><h3>Conclusion</h3><p dir="ltr">The point prevalence of antibiotic use among hospitalized patients in Africa is relatively high and varied between the regions in the continent. The prevalence was higher in the ICU and pediatric medical ward compared to the other wards. Antibiotics were most commonly prescribed for community-acquired infections and for SAP with ceftriaxone, metronidazole, and gentamicin being the most common antibiotics prescribed. Antibiotic stewardship is recommended to address excessive use of SAP and to reduce high rate of antibiotic prescribing in the ICU and pediatric ward.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Racial and Ethnic Health Disparities<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s40615-023-01610-9" target="_blank">https://dx.doi.org/10.1007/s40615-023-01610-9</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_5d16f2b5a52862b121090c0c6f5dc356 |
| identifier_str_mv | 10.1007/s40615-023-01610-9 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/24999089 |
| publishDate | 2023 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence StudiesUsman Abubakar (6433472)Muhammad Salman (799405)Biomedical and clinical sciencesPharmacology and pharmaceutical sciencesHealth sciencesEpidemiologyHealth services and systemsPublic healthPoint prevalenceAfricaAntibiotic prescribingAntibiotic useHospitalized patientsSystematic review<h3>Background</h3><p dir="ltr">There is paucity of data describing the rate and quality indices of antibiotics used among hospitalized patients at continental level in Africa. This systematic review evaluated the pooled prevalence, indications, and types of antibiotics used in hospitals across Africa.</p><h3>Methods</h3><p dir="ltr">Three electronic databases, PubMed, Scopus, and African Journals Online (AJOL), were searched using search terms. Point prevalence studies of antibiotic use in inpatient settings published in English language from January 2010 to November 2022 were considered for selection. Additional articles were identified by checking the reference list of selected articles.</p><h3>Results</h3><p dir="ltr">Of the 7254 articles identified from the databases, 28 eligible articles involving 28 studies were selected. Most of the studies were from Nigeria (n = 9), Ghana (n = 6), and Kenya (n = 4). Overall, the prevalence of antibiotic use among hospitalized patients ranged from 27.6 to 83.5% with higher prevalence in West Africa (51.4–83.5%) and North Africa (79.1%) compared to East Africa (27.6–73.7%) and South Africa (33.6–49.7%). The ICU (64.4–100%; n = 9 studies) and the pediatric medical ward (10.6–94.6%; n = 13 studies) had the highest prevalence of antibiotic use. Community-acquired infections (27.7–61.0%; n = 19 studies) and surgical antibiotic prophylaxis (SAP) (14.6–45.3%; n = 17 studies) were the most common indications for antibiotic use. The duration of SAP was more than 1 day in 66.7 to 100% of the cases. The most commonly prescribed antibiotics included ceftriaxone (7.4–51.7%; n = 14 studies), metronidazole (14.6–44.8%; n = 12 studies), gentamicin (n = 8 studies; range: 6.6–22.3%), and ampicillin (n = 6 studies; range: 6.0–29.2%). The access, watch, and reserved group of antibiotics accounted for 46.3–97.9%, 1.8–53.5%, and 0.0–5.0% of antibiotic prescriptions, respectively. The documentation of the reason for antibiotic prescription and date for stop/review ranged from 37.3 to 100% and 19.6 to 100%, respectively.</p><h3>Conclusion</h3><p dir="ltr">The point prevalence of antibiotic use among hospitalized patients in Africa is relatively high and varied between the regions in the continent. The prevalence was higher in the ICU and pediatric medical ward compared to the other wards. Antibiotics were most commonly prescribed for community-acquired infections and for SAP with ceftriaxone, metronidazole, and gentamicin being the most common antibiotics prescribed. Antibiotic stewardship is recommended to address excessive use of SAP and to reduce high rate of antibiotic prescribing in the ICU and pediatric ward.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Racial and Ethnic Health Disparities<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s40615-023-01610-9" target="_blank">https://dx.doi.org/10.1007/s40615-023-01610-9</a></p>2023-05-08T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s40615-023-01610-9https://figshare.com/articles/journal_contribution/Antibiotic_Use_Among_Hospitalized_Patients_in_Africa_A_Systematic_Review_of_Point_Prevalence_Studies/24999089CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/249990892023-05-08T03:00:00Z |
| spellingShingle | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies Usman Abubakar (6433472) Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Epidemiology Health services and systems Public health Point prevalence Africa Antibiotic prescribing Antibiotic use Hospitalized patients Systematic review |
| status_str | publishedVersion |
| title | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| title_full | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| title_fullStr | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| title_full_unstemmed | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| title_short | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| title_sort | Antibiotic Use Among Hospitalized Patients in Africa: A Systematic Review of Point Prevalence Studies |
| topic | Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Epidemiology Health services and systems Public health Point prevalence Africa Antibiotic prescribing Antibiotic use Hospitalized patients Systematic review |