Southern African Journal of Infectious Diseases (Feb 2025)

Antibiotic prescribing in public primary healthcare centres in Maseru, Lesotho

  • Mapoloko A. Letša,
  • Johanita R. Burger,
  • Irma Kotzé

DOI
https://doi.org/10.4102/sajid.v40i1.692
Journal volume & issue
Vol. 40, no. 1
pp. e1 – e7

Abstract

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Background: Inappropriate prescribing of antibiotics is a global problem. We assessed the prescribing patterns of antibiotics in three public primary healthcare centres (PHCCs) in Maseru, Lesotho. Objectives: A cross-sectional point prevalence survey was employed using patients’ prescription booklets from October 2022 to December 2022. Method: Antibiotics were categorised according to the World Health Organization (WHO) AWaRe classification and assessed by Defined Daily Dose (DDD)/100 outpatients/day to measure relative consumption of each antibiotic as a percentage of total consumption, Access-to-Watch index (AW-I) and Amoxicillin Index (A-I). Results: Of the 624 participants (median age 35 [interquartile range {IQR}: 45–26] years), 71.5% (n = 446) were female. Overall mean (standard deviation [s.d.]) antibiotic consumption was 1.48 (0.13) DDD/100 outpatients/day, with PHCC-1 at 1.64, PHCC-2 at 1.33 and PHCC-3 at 1.47 DDD/100 outpatients/day. The median (IQR) AW-I was 4.64 (3.42–9.45) and the A-I was 1.41 (0.87–1.95). The most frequently prescribed Access group antibiotics included amoxicillin (PHCC-2: 45.9%, overall 1.33 DDD/100 outpatients/day; PHCC-3: 24.5%, 1.47 DDD/100 outpatients/day, and PHCC-1: 23.2%, 1.64 DDD/100 outpatients/day) and doxycycline (PHCC-3: 29.9%, 1.47 DDD/100 outpatients/day, 24.1%, PHCC-2: 1.33 DDD/100 outpatients/day). Erythromycin was the most prescribed Watch group antibiotic for all PHCCs. Conclusion: High consumption of Access-group antibiotics was observed. The Watch group’s antibiotic use, particularly erythromycin, requires the implementation of stewardship programmes. Results may be a baseline for establishing antibiotic stewardship in Lesotho’s PHCCs. Contribution: Our study addressed the scarcity of data on antibiotic prescribing patterns in PHCCs in Lesotho using the AWaRe classification system recommended for monitoring antibiotic prescribing and promoting rational use.

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