Assessing antibiotic prescribing patterns and utilization of microbiological tests results for common bacterial infections in under five inpatients at Ntchisi District Hospital, Malawi
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Date
2021-04-01
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Kamuzu University of Health Sciences
Abstract
Antibiotics have remained useful to humans and animals in the treatment of serious infectious diseases for decades now. Unfortunately, irrational antibiotic use has resulted in the emergency of antimicrobial resistance. The aim of this study was to assess antibiotic prescribing patterns and utilization of microbiological test results in common bacterial infections, and enhance existing interventions for the improvement of rational antibiotic use. This was a hospital based study, designed as prospective cross-sectional, which was conducted at Ntchisi district hospital, Malawi. The study used a structured questionnaire which involved prospectively reviewing and recording information from files of under-five patients admitted in peaditric ward. Convenience sampling method was used to enroll participants in the study. The study enrolled 373 participants who were prescribed antibiotics. The outcomes of the study were to assess antibiotic prescribing patterns in under five inpatients, evaluate utilization of microbiological test results of common bacterial infection in under five patients and find out the correlation or association between antibiotic prescribing pattern and utilization of microbiological test results in under five inpatients. According to Malawi Standard Treatment Guidelines, among the 373 recruited participant 76.68 % were appropriately prescribed antibiotics and 23.32 % were inappropriately prescribed antibiotics (p=<0.001). The most prescribed antibiotics were a combination of Benzyl penicillin and gentamycin 276(74.0%), followed by ceftriaxone 87(23.2%) and metronidazole 10(2.7%) (p=<0.001), 318(85.25%) had antibiotic prescription without a request for microbiological test and only 55(14.75%) had antibiotic prescription with a requested microbiological test (p=<0.001). Among the 55(14.75%) cerebral spinal fluid (CSF) samples sent to the
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laboratory, 46/55 CSF samples were analyzed and all the samples had negative result. Culture and sensitivity was not performed because of lack of laboratory resources. There was no utilization of these microbiological test results to maintain, change or discontinue treatment by the prescribers. It was observed that antibiotic prescriptions were made empirically. The study found that the correlation between antibiotic prescribing pattern and utilization of microbiological test results was not statistically significant (p=0.288).