Evidence map›Paper›PMID 31226974›Full record

ArticleBMC public health2019

Antibiotic use in surgical units of selected hospitals in Ghana: a multi-centre point prevalence survey.

Antoinette A A Bediako-Bowan, Enid Owusu, Appiah-Korang Labi, Noah Obeng-Nkrumah, Gifty Sunkwa-Mills, Stephanie Bjerrum, Japheth Awuletey Opintan, Cynthia Bannerman, Kåre Mølbak, Jørgen Anders Lindholm Kurtzhals and 1 more

Abstract readMulticenter Study
In one paragraph

Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 5 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Antoinette A A Bediako-BowanDepartment of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana. abediako-bowan@ug.edu.gh.ORCID http://orcid.org/0000-0002-9725-1839
Enid OwusuDepartment of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Appiah-Korang LabiDepartment of Microbiology, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana.
Noah Obeng-NkrumahDepartment of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Gifty Sunkwa-MillsDepartment of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Stephanie BjerrumDepartment of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.
Japheth Awuletey OpintanDepartment of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Cynthia BannermanFormerly Institutional Care Division, Ghana Health Service, Accra, Ghana.
Kåre MølbakDepartment of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark.
Jørgen Anders Lindholm KurtzhalsDepartment of Clinical Microbiology, Copenhagen University Hospital (Righospitalet), Copenhagen, Denmark.
Mercy Jemima NewmanDepartment of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.

Funding

Danish International Development Agency 16-PO1-GHA
6 · The paper itself

Abstract

backgroundImproper use of antibiotics leads to the emergence of resistant microorganisms as well as drug toxicity, increased healthcare costs, morbidity and mortality. Globally, an estimated 25-68% of hospitalized patients receive suboptimal antibiotic regimes. Information on the extent of this problem in Ghana is currently limited, particularly in surgical units. To strategize for interventions, we estimated the antibiotic use prevalence in surgical departments in a country-wide point prevalence survey (PPS) in Ghana.

methodsBetween October 2016 and December 2016, we conducted a cross-sectional multi-center country-wide PPS. This involved an audit of in-patients' records from all units/departments of ten systematically selected hospitals in Ghana. Data were collected with a standardized questionnaire, adopted from the European Centre for Disease Prevention and Control. In this report, we present data on antibiotic use from the surgical units.

resultsOf 2107 eligible patients included in the PPS, 540 patients were identified in surgical units, of which 70.7% (382/540) received antibiotic therapy. A total of 636 antibiotic prescriptions were issued to these surgical patients; 224 (58.6%) for treatment, including 50 for treatment of hospital-acquired infections, and 144 (37.7%) for prophylaxis (medical and surgical). Median duration of antibiotic therapy prior to the survey was 5 days (interquartile range (IQR): 3-8 days). Surgical prophylaxis was administered for longer than the recommended one day in 107 of 144 (88.4%) patients. The choice of antibiotics was largely similar for community- and hospital-acquired infections as well as for prophylaxis. Only 3.7% of patients had microbiological analysis done on clinical samples.

conclusionWe found a high prevalence of antibiotic use, with the choice of antibiotics, in some cases, inconsistent with the country's treatment guidelines. Antibiotics were administered for long duration including antibiotics for prophylactic purposes and the majority was started without supporting microbiological analysis. Prescription practices that encourage rational use of antibiotics guided by microbiology and enforcement of antibiotic policy guidelines should be the target for future interventions.

Indexed as

Surgery Department, HospitalAdolescentAdultAgedAnti-Bacterial AgentsAntibiotic ProphylaxisChildChild, PreschoolCross InfectionCross-Sectional StudiesFemaleGhanaHealth Care SurveysHumansInfantInfant, NewbornAnti-Bacterial AgentsAntibiotic useGhanaSurgerySurgical prophylaxis

Identifiers

PMID31226974
PMCPMC6588883

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.