ArticleBMJ open quality2023
Development and evaluation of a continuous quality improvement programme for antimicrobial stewardship in six hospitals in Uganda.
Article in BMJ open quality, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 11 citations in OpenAlex.
- Landscape Analysis of Existing Policies, Laws and Regulations on Antimicrobial Stewardship in 10 Low- and Middle-Income Countries.Antibiotics (Basel, Switzerland) · 2026Article
- Context-specific impact of antimicrobial stewardship on antibiotic use and antibiotic resistance in hospitals in a lower-middle-income country: results from an implementation study with a controlled interrupted time series design in Viet Nam.JAC-antimicrobial resistance · 2026Article
- Antimicrobial stewardship interventions currently implemented at primary healthcare settings across low- and lower-middle-income countries (LLMICS).International health · 2026Article
- Antibiotic use among patients admitted to tertiary hospitals in Uganda: a trend analysis of 2020-2023 point prevalence surveys.BMJ open · 2026Article
- Self-care strategies and interventions to address antimicrobial resistance: evidence review and recommendations for national programs, service providers, caregivers, and self-carers.Frontiers in public health · 2026Review
- Antimicrobial Stewardship Impact on Antibiotic Use in Three Tertiary Hospitals in Zambia: A Comparative Point Prevalence Survey.Antibiotics (Basel, Switzerland) · 2025Article
- Behavioral Nudges to Encourage Appropriate Antimicrobial Use Among Health Professionals in Uganda.Antibiotics (Basel, Switzerland) · 2024Article
- A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned.Biosafety and health · 2024Article
- Enhancing infection prevention and control through hand hygiene compliance in six Ugandan hospitals using quality improvement approaches.Frontiers in public health · 2024Article
- Antimicrobial stewardship in primary health care programs in humanitarian settings: the time to act is now.Antimicrobial resistance and infection control · 2023Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAppropriate antimicrobial use is essential for antimicrobial stewardship (AMS). Ugandan hospitals are making efforts to improve antibiotic use, but improvements have not been sufficiently documented and evaluated.
methodsSix Ugandan hospitals implemented AMS interventions between June 2019 and July 2022. We used the WHO AMS toolkit to set-up hospital AMS programmes and implemented interventions using continuous quality improvement (CQI) techniques and targeting conditions commonly associated with antibiotic misuse, that is, urinary tract infections (UTIs), upper respiratory tract infections (URTIs) and surgical antibiotic prophylaxis (SAP). The interventions included training, mentorship and provision of clinical guidelines to support clinical decision-making. Quarterly antibiotic use surveys were conducted.
resultsData were collected for 7037 patients diagnosed with UTIs. There was an increase in the proportion of patients receiving one antibiotic for the treatment of UTI from 48% during the pre-intervention to 73.2%, p<0.01. There was a 19.2% reduction in the number of antimicrobials per patient treated for UTI p<0.01. There was an increase in use of nitrofurantoin, the first-line drug for the management of UTI. There was an increase in the use of Access antibiotics for managing UTIs from 50.4% to 53.8%. The proportion of patients receiving no antimicrobials for URTI increased from 26.3% at pre-intervention compared with 53.4% at intervention phase, p<0.01. There was a 20.7% reduction in the mean number of antimicrobials per patient for URTI from the pre-intervention to the intervention phase, from 0.8 to 0.6, respectively, p<0.001 and reduction in the number of treatment days, p=0.0163. Among patients undergoing surgery, 49.5% (2212) received SAP during the pre-intervention versus 50.5% (2169) during the intervention.
conclusionsUsing CQI approaches to focus on specific causes of inappropriate antibiotic use led to desirable overall reductions in antibiotic use for URTI and UTI.
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