ArticleJAC-antimicrobial resistance2025
Current status and future direction of antimicrobial stewardship programs and antibiotic prescribing in primary care hospitals in Zambia.
Article in JAC-antimicrobial resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The trial behind it
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Who cites it
3 citing papers in PubMed.
- Antibiotic utilization in outpatient and inpatient hospitals in Zambia: a systematic review, key findings and public health implications.Infection prevention in practice · 2026Review
- Diagnostic Stewardship Trends and Antimicrobial Resistance Profiles of Bacteria Isolated in Zambia: A Five-Year Retrospective Study (2020-2024).Antibiotics (Basel, Switzerland) · 2025Article
- Development of the Zambian Standard Treatment Guidelines in the Animal Health Sector: A Key Step in Advancing Antimicrobial Stewardship.Antibiotics (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
25 authors.
Funding
Abstract
Background: Antimicrobial Stewardship Programs (ASPs) intended to optimize antibiotic use will be more effective if informed by the current status and patterns of antibiotic utilisation. In Zambia's primary healthcare (PHC) settings, data on ASPs and antibiotic utilisation were inadequate to guide improvements. As a first step, this study assessed antibiotic prescribing and ASP core elements among PHC first-level hospitals (FLHs) in Zambia. Methods: A point prevalence survey was conducted at the five FLHs in Lusaka using the Global-PPS Results: Antibiotic use prevalence was 79.8% (146/183). A total of 220 antibiotic prescription encounters were recorded among inpatients, with ceftriaxone (J01DD04, Watch) being the most (50.0%) prescribed. Over 90.0% (202) of the antibiotic prescriptions targeted suspected community-acquired infections, but only 36.8% (81) were compliant with national treatment guidelines. ASP core element implementation was 36.0% (16.2/45), with only two hospitals achieving over 50.0%. The most deficient core elements were accountability, action, tracking, and reporting. Conclusions: ASP implementation in Zambia's FLHs providing PHC was sub-optimal, with high antibiotic prescribing rates, frequent use of broad-spectrum Watch group antibiotics, and low compliance with national treatment guidelines. As key ways forward, ASPs in Zambia's PHC require strengthening by adapting the WHO AWaRe recommendations and improving accountability, actions, tracking, and reporting antibiotic use to improve stewardship practice and reduce AMR.
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Registered trials
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