Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented
Nikki D’Arcy,
Diane Ashiru-Oredope,
Omotayo Olaoye,
Daniel Afriyie,
Zainab Akello,
Daniel Ankrah,
Derrick Mawuena Asima,
David C. Banda,
Scott Barrett,
Claire Brandish,
Joseph Brayson,
Peter Benedict,
Cornelius C. Dodoo,
Frances Garraghan,
Josephyn Hoyelah,
Yogini Jani,
Freddy Eric Kitutu,
Ismail Musoke Kizito,
Appiah-Korang Labi,
Mariyam Mirfenderesky,
Sudaxshina Murdan,
Caoimhe Murray,
Noah Obeng-Nkrumah,
William J’Pathim Olum,
Japheth Awuletey Opintan,
Edwin Panford-Quainoo,
Ines Pauwels,
Israel Sefah,
Jacqueline Sneddon,
Anja St. Clair Jones,
Ann Versporten
Affiliations
Nikki D’Arcy
Commonwealth Partnerships Programme on Antimicrobial Stewardship, Commonwealth Pharmacists Association, London E1W 1AW, UK
Diane Ashiru-Oredope
Commonwealth Partnerships Programme on Antimicrobial Stewardship, Commonwealth Pharmacists Association, London E1W 1AW, UK
Omotayo Olaoye
Commonwealth Partnerships Programme on Antimicrobial Stewardship, Commonwealth Pharmacists Association, London E1W 1AW, UK
Department of Pharmacy, University Teaching Hospital, Lusaka P.O. Box 50001, Zambia
Scott Barrett
Pharmacy Department, North Tyneside Hospital, Northumbria Healthcare NHS Foundation Trust, Rake Lane, North Shields NE29 8NH, UK
Claire Brandish
Buckinghamshire Healthcare NHS Trust, Amersham HP7 0JD, UK
Joseph Brayson
Pharmacy Department, North Tyneside Hospital, Northumbria Healthcare NHS Foundation Trust, Rake Lane, North Shields NE29 8NH, UK
Peter Benedict
Kilimanjaro Christian Medical Centre, Moshi P.O. Box 3010, Tanzania
Cornelius C. Dodoo
School of Pharmacy, University of Health and Allied Sciences, PMB 31, Ho, Ghana
Frances Garraghan
Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
Josephyn Hoyelah
St. Mary’s Hospital Lacor, Gulu P.O. Box 180, Uganda
Yogini Jani
Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK
Freddy Eric Kitutu
Sustainable Pharmaceutical Systems (SPS) Unit, Pharmacy Department, School of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
Medical Microbiology Department, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
Edwin Panford-Quainoo
Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
Ines Pauwels
Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
Israel Sefah
Department of Pharmacy, Keta Municipal Hospital, Keta-Dzelukope P.O. Box WT82, Ghana
Jacqueline Sneddon
Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Delta House, 50 West Nile Street, Glasgow G1 2NP, UK
Anja St. Clair Jones
Brighton and Sussex University Hospitals NHS Trust, Brighton BN1 9PX, UK
Ann Versporten
Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base.
