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贝宁阿波美卡拉维/索阿瓦地区大学医院(CHUZ/AS)的抗生素使用情况:一项现况调查。

Antibiotic use at the Centre Hospitalier Universitaire de Zone d'Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin: a point prevalence survey.

作者信息

Gnimavo Morelle Sèssiwèdé, Boya Bawa, Mudenda Steward, Allabi Aurel Constant

机构信息

Laboratory of Pharmacology and Toxicology, University of Abomey-Calavi, 05 BP 1604 Cotonou, Benin.

Teaching Hospital of Abomey-Calavi/Sô-Ava, 05 BP 1604 Contonou, Benin.

出版信息

JAC Antimicrob Resist. 2025 Jan 10;7(1):dlae220. doi: 10.1093/jacamr/dlae220. eCollection 2025 Feb.

Abstract

BACKGROUND

Antimicrobial stewardship promotes the appropriate use of antibiotics to prevent the emergence and spread of antimicrobial resistance. This study evaluated the use of antibiotics using a point prevalence survey at the Centre Hospitalier Universitaire de Zone d'Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin.

METHODS

This cross-sectional study utilized the WHO point prevalence survey methodology for monitoring antibiotic use among inpatients in hospitals. The survey was conducted from 11 January 2022 to 19 January 2022 among hospitalized patients before 8:00 a.m. on the day of the survey.

RESULTS

Of the 111 inpatient medical files reviewed, the prevalence of antibiotic use was 82.9%. The number of antibiotics received per patient ranged from 1 to 5, with a mean of 2.45 ± 1.11 and a median of 2. The most commonly prescribed class of antibiotics was beta-lactams (46.7%), aminoglycosides (20.6%) and nitroimidazoles (19.7%). According to the WHO AWaRe classification, 30.4% of inpatients received the Access group of antibiotics and 44% received a combination of Access and Watch group antibiotics; treatment was empiric in 94.5% of encounters. Only 22.7% of patients were treated based on microbiological examination/culture and sensitivity testing.

CONCLUSIONS

This study found a high prevalence of antibiotic use among inpatients at the CHUZ/AS Tertiary Care Hospital in Benin. The most prescribed antibiotics were ampicillin, metronidazole and ceftriaxone. Consequently, the study found a low use of culture and sensitivity testing to guide treatment, particularly in the paediatric and surgical population, and the preference for broad-spectrum antibiotics suggests that antibiotic use at the CHUZ/AS Tertiary Care is not optimal. Therefore, antimicrobial stewardship programmes, policies and guidelines must be instigated and strengthened to address these gaps and promote rational use of antibiotics.

摘要

背景

抗菌药物管理促进抗生素的合理使用,以防止抗菌药物耐药性的出现和传播。本研究在贝宁的阿波美卡拉维/索阿瓦大学中心医院(CHUZ/AS)通过现患率调查评估了抗生素的使用情况。

方法

这项横断面研究采用世界卫生组织现患率调查方法来监测医院住院患者的抗生素使用情况。该调查于2022年1月11日至19日对调查当天上午8:00之前住院的患者进行。

结果

在审查的111份住院病历中,抗生素使用现患率为82.9%。每位患者接受的抗生素数量为1至5种,平均为2.45±1.11种,中位数为2种。最常开具的抗生素类别是β-内酰胺类(46.7%)、氨基糖苷类(20.6%)和硝基咪唑类(19.7%)。根据世界卫生组织的AWaRe分类,30.4%的住院患者接受了准入组抗生素,44%的患者接受了准入组和观察组抗生素的联合使用;94.5%的治疗是经验性的。只有22.7%的患者根据微生物学检查/培养和药敏试验进行治疗。

结论

本研究发现贝宁CHUZ/AS三级护理医院住院患者中抗生素使用率很高。最常开具的抗生素是氨苄西林、甲硝唑和头孢曲松。因此,该研究发现用于指导治疗的培养和药敏试验使用率较低,尤其是在儿科和外科人群中,而且对广谱抗生素的偏好表明CHUZ/AS三级护理医院的抗生素使用并不理想。因此,必须启动并加强抗菌药物管理计划、政策和指南,以弥补这些差距并促进抗生素的合理使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8380/11719636/68b474d0badf/dlae220f1.jpg

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