Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries
Rattachement africain : Tanzanie, Kenya, us, lk. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: To develop effective antimicrobial stewardship programs (ASPs) for low- and middle-income countries (LMICs), it is important to identify key targets for improving antimicrobial use. We sought to systematically describe the prevalence and patterns of antimicrobial use in three LMIC hospitals. Methods: Consecutive patients admitted to the adult medical wards in three tertiary care hospitals in Tanzania, Kenya, and Sri Lanka were enrolled in 2018-2019. The medical record was reviewed for clinical information including type and duration of antimicrobials prescribed, indications for antimicrobial use, and microbiologic testing ordered. Results: A total of 3,149 patients were enrolled during the study period: 1,103 from Tanzania, 750 from Kenya, and 1,296 from Sri Lanka. The majority of patients were male (1,783, 56.6% overall) with a median age of 55 years (IQR 38-68). Of enrolled patients, 1,573 (50.0%) received antimicrobials during their hospital stay: 35.4% in Tanzania, 56.5% in Kenya, and 58.6% in Sri Lanka. At each site, the most common indication for antimicrobial use was lower respiratory tract infection (LRTI; 40.2%). However, 61.0% received antimicrobials for LRTI in the absence of LRTI signs on chest radiography. Among patients receiving antimicrobials, tools to guide antimicrobial use were under-utilized: microbiologic cultures in 12.0% and microbiology consultation in 6.5%. Conclusion: Antimicrobials were used in a substantial proportion of patients at tertiary care hospitals across three LMIC sites. Future ASP efforts should include improving LRTI diagnosis and treatment, developing antibiograms to direct empiric antimicrobial use, and increasing use of microbiologic tests.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries
- Date Crossref
- 25/04/2022
- Éditeur
- Frontiers Media SA
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Kilimanjaro Christian Medical Centre Tanzanie (code pays fourni par la source)Établissement de santé
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Moi University Eldoret, Kenya (code pays fourni par la source)Université ou école supérieure
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Duke University pays non établi dans la noticeUniversité ou école supérieure
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Center for Neuro-Oncology pays non établi dans la noticeStructure de recherche
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Duke Institute for Health Innovation pays non établi dans la noticeInstitution
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University of Ruhuna pays non établi dans la noticeUniversité ou école supérieure
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Teaching Hospital Kandy pays non établi dans la noticeÉtablissement de santé
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The Ohio State University pays non établi dans la noticeUniversité ou école supérieure
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Campbell University pays non établi dans la noticeUniversité ou école supérieure
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Community Health Department Moshi, Tanzanie (pays nommé en fin d’affiliation)Institution
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Kilimanjaro Christian Medical University College (KCMUCo) Institute of Public Health Moshi, Tanzanie (pays nommé en fin d’affiliation)Université ou école supérieure
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Kilimanjaro Christian Research Institute Moshi, Tanzanie (pays nommé en fin d’affiliation)Structure de recherche
Kilimanjaro Christian Medical Centre (Tanzanie), Moi University (Eldoret, Kenya) et Duke University, avec 9 autres affiliations. Pays d’affiliation : Tanzanie, Kenya.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.