ArticleThe Journal of antimicrobial chemotherapy2016
Extensive antibiotic prescription rate among hospitalized patients in Uganda: but with frequent missed-dose days.
Article in The Journal of antimicrobial chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Antimicrobial prescription patterns in East Africa: a systematic review.Systematic reviews · 2023Pooled it
- Health system and treatment regimen determinants of delayed first-dose antibiotic administration in hospitalized adults in two public health facilities in Kampala, Uganda.BMC health services research · 2026Article
- Health system and treatment regimen determinants of delayed first-dose antibiotic administration in hospitalized adults in Uganda.Research square · 2026Article
- Antibiotic use among patients admitted to tertiary hospitals in Uganda: a trend analysis of 2020-2023 point prevalence surveys.BMJ open · 2026Article
- Patterns of antibiotic use for acute febrile illness in resource-limited settings: a multicenter study in DR Congo, Kenya and Uganda.Frontiers in public health · 2026Article
- Evaluation of Ceftriaxone Utilization in Three Regional Referral Hospitals in Uganda: A Prospective Multicentre Study.Infection and drug resistance · 2026Article
- Prevalence of Missed Medication Doses and Outcomes of Hospitalized Patients Living with HIV in Uganda.Drug, healthcare and patient safety · 2026Article
- Multiple antimicrobial resistance indices of Staphylococcus aureus from the nares of goats and slaughterhouse attendants in Kampala city, Uganda- a cross sectional study.BMC microbiology · 2025Article
- Antibiotic consumption and utilization at a large tertiary care level hospital in Uganda: A point prevalence survey.PloS one · 2025Article
- High Prevalence of Antimicrobial Prescribing Among Public Health Facilities in Central Uganda: Findings from Point Prevalence Survey.Infection and drug resistance · 2025Article
- Effect of an Educational Intervention on Nurses' Knowledge Regarding Use of Modified Early Warning Score in Recognition of Critical Illness.Open access emergency medicine : OAEM · 2025Article
- Article
- 'Some patients demand for a prescription of an antibiotic': an assessment of barriers and facilitators to rational antimicrobial use in a private health facility in Uganda.JAC-antimicrobial resistance · 2024Article
- Challenges of Antibiotic Formulations and Administration in the Treatment of Bloodstream Infections in Children Under Five Admitted to Kisantu Hospital, Democratic Republic of Congo.The American journal of tropical medicine and hygiene · 2023Article
- A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital.PLOS global public health · 2023Article
- Point Prevalence Survey of Antimicrobial Use during the COVID-19 Pandemic among Different Hospitals in Pakistan: Findings and Implications.Antibiotics (Basel, Switzerland) · 2022Article
- Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future.Antibiotics (Basel, Switzerland) · 2022Article
- Article
- Drivers of irrational use of antibiotics among children: a mixed-method study among prescribers and dispensers in Tanzania.BMC health services research · 2022Article
- Antibiotic prescription rationality and associated in-patient treatment outcomes in children under-five with severe pneumonia at Bwizibwera health center IV, Mbarara District, South-Western Uganda.Pneumonia (Nathan Qld.) · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesTo describe the patterns of systemic antibiotic use and missed-dose days and detail the prescription, dispensing and administration of frequently used hospital-initiated antibiotics among Ugandan inpatients.
methodsThis was a prospective cohort of consented adult inpatients admitted on the medical and gynaecological wards of the 1790 bed Mulago National Referral Hospital.
resultsOverall, 79% (603/762; 95% CI: 76%-82%) of inpatients received at least one antibiotic during hospitalization while 39% (300/762; 95% CI: 36%-43%) had used at least one antibiotic in the 4 weeks pre-admission; 1985 antibiotic DDDs, half administered parenterally, were consumed in 3741 inpatient-days. Two-fifths of inpatients who received at least one of the five frequently used hospital-initiated antibiotics (ceftriaxone, metronidazole, ciprofloxacin, amoxicillin and azithromycin) missed at least one antibiotic dose-day (44%, 243/558). The per-day risk of missed antibiotic administration was greatest on day 1: ceftriaxone (36%, 143/398), metronidazole (27%, 67/245), ciprofloxacin (34%, 39/114) and all inpatients who missed at least one dose-day of prescribed amoxicillin and azithromycin. Most patients received fewer doses than were prescribed: ceftriaxone (74%, 273/371), ciprofloxacin (90%, 94/105) and metronidazole (97%, 222/230). Of prescribed doses, only 62% of ceftriaxone doses (1178/1895), 35% of ciprofloxacin doses (396/1130) and 27% of metronidazole doses (1043/3862) were administered. Seven percent (13/188) of patients on intravenous metronidazole and 6% (5/87) on intravenous ciprofloxacin switched to oral route.
conclusionsHigh rates of antibiotic use both pre-admission and during hospitalization were observed, with low parenteral/oral switch of hospital-initiated antibiotics. Underadministration of prescribed antibiotics was common, especially on the day of prescription, risking loss of efficacy and antibiotic resistance.
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