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Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys
INTRODUCTION: inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to summarize the available evidence on the point prevalence and pattern of antimicrobial and/or antibiotic prescription in Afr...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460099/ https://www.ncbi.nlm.nih.gov/pubmed/37637407 http://dx.doi.org/10.11604/pamj.2023.45.67.36191 |
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author | Okedo-Alex, Ijeoma Nkem Akamike, Ifeyinwa Chizoba Iyamu, Ihoghosa Umeokonkwo, Chukwuma David |
author_facet | Okedo-Alex, Ijeoma Nkem Akamike, Ifeyinwa Chizoba Iyamu, Ihoghosa Umeokonkwo, Chukwuma David |
author_sort | Okedo-Alex, Ijeoma Nkem |
collection | PubMed |
description | INTRODUCTION: inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to summarize the available evidence on the point prevalence and pattern of antimicrobial and/or antibiotic prescription in Africa. METHODS: this review was carried out between April and September 2021 and identified published studies up until March 2021 on the point prevalence of antibiotic and/or antimicrobial use in Africa. Sources searched were OVID, PubMed, EMBASE, CINAHL, Web of Science, Google Scholar, Google, and African Journal Online (AJOL). Observational studies that reported prevalence published in English language were included. Covidence systematic review software was used for this review. A form for data extraction using domains culled from the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) was developed on Covidence. Screening of studies for eligibility was done independently by two reviewers. Critical Appraisal tool for use in Joanna Briggs Institute (JBI) Systematic Reviews for prevalence studies was used for quality appraisal. RESULTS: a total of 17 studies that met the inclusion criteria were included in the review. The overall prevalence of antimicrobial/antibiotic use among inpatients in these studies ranged from 40.7% to 97.6%. The median antimicrobial/antibiotic use was 61.3 [IQR= 45.5-72.1]. The highest use of antimicrobials was reported among studies from Nigeria with a prevalence of 97.6%. The most prescribed antibiotics were the beta-lactam penicillin (Amoxicillin, clavulanic acid) (86.9%), and third generation cephalosporins (55.0%). There was general preference for parenteral route of administration of the antimicrobial agents (40-70%). Use for community acquired infections (28.0-79.5%) was the main reason for use. Majority of the prophylactic use of antimicrobial agents were for surgical prophylaxis. Conclusion: the high prevalence of antimicrobial use in Africa reinforces the need for continued surveillance and concerted efforts to institutionalize and support antimicrobial stewardship for prescribers in health institutions in the African region. |
format | Online Article Text |
id | pubmed-10460099 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The African Field Epidemiology Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-104600992023-08-27 Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys Okedo-Alex, Ijeoma Nkem Akamike, Ifeyinwa Chizoba Iyamu, Ihoghosa Umeokonkwo, Chukwuma David Pan Afr Med J Review INTRODUCTION: inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to summarize the available evidence on the point prevalence and pattern of antimicrobial and/or antibiotic prescription in Africa. METHODS: this review was carried out between April and September 2021 and identified published studies up until March 2021 on the point prevalence of antibiotic and/or antimicrobial use in Africa. Sources searched were OVID, PubMed, EMBASE, CINAHL, Web of Science, Google Scholar, Google, and African Journal Online (AJOL). Observational studies that reported prevalence published in English language were included. Covidence systematic review software was used for this review. A form for data extraction using domains culled from the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) was developed on Covidence. Screening of studies for eligibility was done independently by two reviewers. Critical Appraisal tool for use in Joanna Briggs Institute (JBI) Systematic Reviews for prevalence studies was used for quality appraisal. RESULTS: a total of 17 studies that met the inclusion criteria were included in the review. The overall prevalence of antimicrobial/antibiotic use among inpatients in these studies ranged from 40.7% to 97.6%. The median antimicrobial/antibiotic use was 61.3 [IQR= 45.5-72.1]. The highest use of antimicrobials was reported among studies from Nigeria with a prevalence of 97.6%. The most prescribed antibiotics were the beta-lactam penicillin (Amoxicillin, clavulanic acid) (86.9%), and third generation cephalosporins (55.0%). There was general preference for parenteral route of administration of the antimicrobial agents (40-70%). Use for community acquired infections (28.0-79.5%) was the main reason for use. Majority of the prophylactic use of antimicrobial agents were for surgical prophylaxis. Conclusion: the high prevalence of antimicrobial use in Africa reinforces the need for continued surveillance and concerted efforts to institutionalize and support antimicrobial stewardship for prescribers in health institutions in the African region. The African Field Epidemiology Network 2023-05-29 /pmc/articles/PMC10460099/ /pubmed/37637407 http://dx.doi.org/10.11604/pamj.2023.45.67.36191 Text en Copyright: Ijeoma Nkem Okedo-Alex et al. https://creativecommons.org/licenses/by/4.0/The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Okedo-Alex, Ijeoma Nkem Akamike, Ifeyinwa Chizoba Iyamu, Ihoghosa Umeokonkwo, Chukwuma David Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys |
title | Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys |
title_full | Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys |
title_fullStr | Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys |
title_full_unstemmed | Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys |
title_short | Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys |
title_sort | pattern of antimicrobial prescription in africa: a systematic review of point prevalence surveys |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460099/ https://www.ncbi.nlm.nih.gov/pubmed/37637407 http://dx.doi.org/10.11604/pamj.2023.45.67.36191 |
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