A point prevalence survey of antimicrobial use in hospitalized patients at two hospitals in Western Kenya: 2022

Abstract

Abstract Information from a point prevalence survey (PPS) can guide antimicrobial stewardship programs (ASPs). The aim of the present study was to document the use of antimicrobial agents at two hospitals in Western Kenya, namely Bungoma County Referral Hospital (BCRH) and Webuye County Hospital (WCH). The World Health Organization (WHO) Global Point Prevalence Survey (G-PPS) tool was used to collect sociodemographic information from study participants, the type of antimicrobial agents used, indications for antimicrobial use, and diagnostic tests conducted on participants. Files were selected over 24 h, data was abstracted between July and October 2022, and descriptive analysis carried out on SPSS version 26. Among the 361 patients, 223 (61.8%) were on antibiotics. The most common antibiotics used were ceftriaxone (123/237; 34.5%), metronidazole (89/237; 24.9%), and flucloxacillin (36/237; 10.1%). Most (60/237; 25.4%) antibiotics at WCH were prescribed empirically, while most (46/237; 19.5%) of the antibiotics at BCRH were prescribed for prophylaxis. Pneumonia was the leading indication for antibiotic prescriptions at BCRH (18/169, 9.5%), while clinical sepsis (17/169; 9.9%) was the leading indication for antibiotic prescriptions at the WCH. About 7% (16/237) of the patients who had an antibiotic prescribed were subjected to culture and sensitivity testing, but only 9/16 (81.8%) received the results of the antimicrobial susceptibility tests within the study period. Penicillins and Cephalosporins were widely used, prescribing/clinical practices vary from one hospital to another, and microbiological tests were underutilized in the study area. There is a need for enhanced antimicrobial and diagnostic stewardship in the study areas.

Keywords

• Point prevalence survey
• Antimicrobial resistance
• Antimicrobial stewardship
• Antimicrobial use
• Diagnostic stewardship
• Western Kenya