Preprint Article Version 1 This version is not peer-reviewed

Prescription Practices and Usage of Antimicrobials in a Tertiary Teaching Hospital in Rwanda: A Call for Antimicrobial Stewardship

Acsa Igizeneza
* ,
Leopold Bitunguhari
,
Florence Masaisa
,
Innocent Hahirwa
,
Lorette Doris Uwamahoro
,
Osee Sebatunzi
,
Nathalie Umugwaneza
,
Ines Pauwels
,
Ann Versporten
,
Erika Vlieghe
,
Ayman Ahmed
,
Jean Claude Semuto Ngabonziza
,
Caroline Theunissen
Version 1 : Received: 30 July 2024 / Approved: 31 July 2024 / Online: 2 August 2024 (09:39:37 CEST)

How to cite: Igizeneza, A.; Bitunguhari, L.; Masaisa, F.; Hahirwa, I.; Uwamahoro, L. D.; Sebatunzi, O.; Umugwaneza, N.; Pauwels, I.; Versporten, A.; Vlieghe, E.; Ahmed, A.; Ngabonziza, J. C. S.; Theunissen, C. Prescription Practices and Usage of Antimicrobials in a Tertiary Teaching Hospital in Rwanda: A Call for Antimicrobial Stewardship. Preprints 2024, 2024072545. https://doi.org/10.20944/preprints202407.2545.v1 Igizeneza, A.; Bitunguhari, L.; Masaisa, F.; Hahirwa, I.; Uwamahoro, L. D.; Sebatunzi, O.; Umugwaneza, N.; Pauwels, I.; Versporten, A.; Vlieghe, E.; Ahmed, A.; Ngabonziza, J. C. S.; Theunissen, C. Prescription Practices and Usage of Antimicrobials in a Tertiary Teaching Hospital in Rwanda: A Call for Antimicrobial Stewardship. Preprints 2024, 2024072545. https://doi.org/10.20944/preprints202407.2545.v1

Abstract

Antimicrobial resistance (AMR) is a global threat associated with high morbidity and mortality, particularly in low- and middle-income countries. Inappropriate use of antimicrobials is one of the major drivers of the AMR pandemic. This study aims to evaluate the rate and quality of antimicrobial prescription and use at the University Teaching Hospital of Kigali, a tertiary referral and teaching hospital. A point prevalence survey (PPS) of antimicrobial prescription was conducted using the Global PPS tool, including the healthcare-acquired infections (HAI)-module. On the day of PPS, 39.3% (145/369) of the patients were prescribed at least one antimicrobial. Out of 259 prescribed antimicrobials, 232 (89.6%) were antibacterials of which 151 (65.1%) belonged to the Watch-group of the WHO AWaRe classification. Top three antibiotics prescribed were cefotaxime (87; 37.5%), parenteral metronidazole (31; 13.4%); and meropenem (23; 9.9%). Stop/review of the prescribed antimicrobials was documented in 27/259 prescriptions (10.4%). Surgical prophylaxis (SP) was prescribed for more than one day in 83.3% of 61. Samples for culture were sent for 27.1% (63/232) of all prescribed antibiotics. This PPS showed a high usage of Watch antibiotics, prolonged surgical prophylaxis and other poor-quality indicators. Therefore, there is an urgent need for antimicrobial stewardship interventions.

Keywords

Antimicrobial stewardship; Low- and middle-income countries; Point Prevalence Survey; Rwanda tertiary hospital; teaching hospital; antimicrobial resistance.

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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