ABSTRACT
Background: The inappropriate use of antibiotics results in the emergence of antimicrobial resistance and adverse clinical and economic outcomes in hospital in-patients. A lack of institutional and national antibiotic guidelines promotes inappropriate antibiotic use. The objectives of this study are to evaluate the appropriateness of antibiotic prescribing, and the quality of antibiotic use in medical wards of the Lagos University Teaching Hospital, Lagos, Nigeria. Methodology: This was a descriptive cross-sectional study of patients admitted and placed on antibiotics in the medical wards of Lagos University Teaching Hospital between July 2013 and August 2014. The appropriateness of antibiotic therapy was determined by compliance with the guidelines of the Infectious Diseases Society of America (IDSA). Results: A total of 350 hospitalized patients on antibiotic therapy during the period of the study were reviewed, including 197 (56.3%) males and 153 females (43.7%). The mean age of the patients was 48.7±17.6 years and a total of 539 initial antibiotics were empirically prescribed. Antibiotic therapy was considered inappropriate in 290 (82.9%) patients, of which 131 (37.4%) patients had no evidence of infection. Pneumonia (23.1%) was the most common indication for antibiotic use, out of which 59.3% had inappropriate antibiotic therapy. Overall, the most frequently prescribed initial empirical antibiotic classes were imidazole derivatives (32.4%) and cephalosporins (22.0%), while the most frequently prescribed inappropriate antibiotic classes were carbapenems (100.0%) and quinolones (89.3%). Conclusion: The study revealed a high rate of inappropriate antibiotic therapy. There is an imperative need to establish antimicrobial stewardship programmes to curb the inappropriate use of antibiotics in the hospital.
Subject(s)
Male , Female , Drug Prescriptions , Drug Resistance, Microbial , Drug Overdose , Anti-Bacterial AgentsABSTRACT
But : Notre etude avait pour objectif d'etudier les facteurs associes a la faible couverture en Vaccin Anti Tetanique deuxieme dose (VAT2+) chez les femmes enceintes dans la Zone Sanitaire de Zogbodomey Zakpota Bohicon au Benin. Materiels et Methodes: Une etude transversale; descriptive et analytique a ete menee en juin juillet 2013 et apporte sur les meres d'enfants de 0 11 mois. La methode de couverture vaccinale en grappes de l'OMS a ete utilisee. Les donnees ont ete analysees avec Epi Info 7 et Stata 11. La regression logistique a ete utilisee pour determiner les facteurs associes a la VAT2+. Resultats: La couverture en VAT2 + des 210 meres enquetees etait de 61;7 IC95 =[61;4 62;0]. Les facteurs associes a la couverture en VAT2+ etaient : le nombre de CPN; le recours a un centre de sante prive; la connaissance et l'explication du calendrier vaccinal; l'utilisation des medias; le statut matrimonial; la profession; le temps d'attente; la residence; la peur des reactions secondaires; la permanence des services de vaccination; le niveau d'instruction; la distance; le soutien de la famille. Conclusion : Les mesures visant a ameliorer la couverture en VAT2+ doivent davantage mettre l'accent sur ces facteurs pour esperer eliminer le tetanos maternel et neonatal