Evidence map›Paper›PMID 32781162›Full record

ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2020

Antibiotic use in Kenyan public hospitals: Prevalence, appropriateness and link to guideline availability.

Michuki Maina, Paul Mwaniki, Edwin Odira, Nduku Kiko, Jacob McKnight, Constance Schultsz, Mike English, Olga Tosas-Auguet

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Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

48 citing papers in PubMed, 2 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

8 authors.

Michuki MainaKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100 Nairobi, Kenya; Department of Global Health, Amsterdam UMC, University of Amsterdam, Postbus 22660,1100 DD Amsterdam, The Netherlands. Electronic address: mmaina@kemri-wellcome.org.
Paul MwanikiKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100 Nairobi, Kenya.
Edwin OdiraDepartment of Surgery, Kitui County Referral Hospital PO Box 33-90200 Kitui, Kenya.
Nduku KikoDepartment of Medicine, Kenyatta National Hospital, PO Box 20723-00202 Nairobi, Kenya.
Jacob McKnightThe University of Oxford, Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, OX1 3SY, Oxford, United Kingdom.
Constance SchultszDepartment of Global Health, Amsterdam UMC, University of Amsterdam, Postbus 22660,1100 DD Amsterdam, The Netherlands; Amsterdam Institute for Global Health and Development- AHTC, Tower C4, Paasheuvelweg 25 1105 BP Amsterdam, The Netherlands.
Mike EnglishKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100 Nairobi, Kenya; The University of Oxford, Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, OX1 3SY, Oxford, United Kingdom.
Olga Tosas-AuguetThe University of Oxford, Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, OX1 3SY, Oxford, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine prescription patterns and explore to what extent guidelines are available and how they might influence treatment appropriateness among hospitalised patients in Kenyan hospitals.

methodsData on antimicrobial usage were collected from hospitalised patients across 14 Kenyan public hospitals. For each prescription, appropriateness of treatment was defined using available local and international treatment guidelines and through consensus with local medical specialists. Association between appropriate treatment, guideline availability and other possible explanatory factors was explored using univariate and multiple regression analysis.

resultsThere were 1675 (46.7%) of the 3590 hospitalised patients on antimicrobials with 3145(94%) of the 3363 antimicrobial prescriptions being antibiotics. Two patients (0.1%), had treatment based on available antibiotic susceptibility tests. Appropriate treatment was assessed in 1502 patients who had a single diagnosis. Of these, 805 (53.6%) received appropriate treatment. Physical availability of treatment guidelines increased the odds of receiving appropriate treatment Odds Ratio 6.44[95% CI 4.81-8.64].

conclusionAppropriate antibiotic prescription remains a challenge in Kenyan public hospitals. This may be improved by the availability of context-specific, up-to-date, and readily accessible treatment guidelines across all the departments, and by providing better diagnostic support.

Indexed as

Drug Utilization ReviewAdultAnti-Bacterial AgentsChildDrug PrescriptionsFemaleHospitals, PublicHumansInfant, NewbornKenyaMalePrevalenceAnti-Bacterial AgentsAntibioticsAntimicrobial resistancePoint prevalence survey

Identifiers

PMID32781162
PMCPMC7562818

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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.