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Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries.

Publication ,  Journal Article
Muro, FJ; Lyamuya, FS; Kwobah, C; Bollinger, J; Bodinayake, CK; Nagahawatte, A; Piyasiri, B; Kurukulasooriya, R; Ali, S; Mallya, R; Rolfe, R ...
Published in: Front Public Health
2022

BACKGROUND: To develop effective antimicrobial stewardship programs (ASPs) for low- and middle-income countries (LMICs), it is important to identify key targets for improving antimicrobial use. We sought to systematically describe the prevalence and patterns of antimicrobial use in three LMIC hospitals. METHODS: Consecutive patients admitted to the adult medical wards in three tertiary care hospitals in Tanzania, Kenya, and Sri Lanka were enrolled in 2018-2019. The medical record was reviewed for clinical information including type and duration of antimicrobials prescribed, indications for antimicrobial use, and microbiologic testing ordered. RESULTS: A total of 3,149 patients were enrolled during the study period: 1,103 from Tanzania, 750 from Kenya, and 1,296 from Sri Lanka. The majority of patients were male (1,783, 56.6% overall) with a median age of 55 years (IQR 38-68). Of enrolled patients, 1,573 (50.0%) received antimicrobials during their hospital stay: 35.4% in Tanzania, 56.5% in Kenya, and 58.6% in Sri Lanka. At each site, the most common indication for antimicrobial use was lower respiratory tract infection (LRTI; 40.2%). However, 61.0% received antimicrobials for LRTI in the absence of LRTI signs on chest radiography. Among patients receiving antimicrobials, tools to guide antimicrobial use were under-utilized: microbiologic cultures in 12.0% and microbiology consultation in 6.5%. CONCLUSION: Antimicrobials were used in a substantial proportion of patients at tertiary care hospitals across three LMIC sites. Future ASP efforts should include improving LRTI diagnosis and treatment, developing antibiograms to direct empiric antimicrobial use, and increasing use of microbiologic tests.

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Published In

Front Public Health

DOI

EISSN

2296-2565

Publication Date

2022

Volume

10

Start / End Page

848802

Location

Switzerland

Related Subject Headings

  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Female
  • Developing Countries
  • Antimicrobial Stewardship
  • Anti-Infective Agents
  • Anti-Bacterial Agents
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Muro, F. J., Lyamuya, F. S., Kwobah, C., Bollinger, J., Bodinayake, C. K., Nagahawatte, A., … Tillekeratne, L. G. (2022). Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries. Front Public Health, 10, 848802. https://doi.org/10.3389/fpubh.2022.848802
Muro, Florida J., Furaha S. Lyamuya, Charles Kwobah, John Bollinger, Champica K. Bodinayake, Ajith Nagahawatte, Bhagya Piyasiri, et al. “Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries.Front Public Health 10 (2022): 848802. https://doi.org/10.3389/fpubh.2022.848802.
Muro FJ, Lyamuya FS, Kwobah C, Bollinger J, Bodinayake CK, Nagahawatte A, et al. Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries. Front Public Health. 2022;10:848802.
Muro, Florida J., et al. “Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries.Front Public Health, vol. 10, 2022, p. 848802. Pubmed, doi:10.3389/fpubh.2022.848802.
Muro FJ, Lyamuya FS, Kwobah C, Bollinger J, Bodinayake CK, Nagahawatte A, Piyasiri B, Kurukulasooriya R, Ali S, Mallya R, Rolfe R, Ruwanpathirana A, Sheng T, Østbye T, Drew R, Kussin P, Woods CW, Anderson DJ, Mmbaga BT, Tillekeratne LG. Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries. Front Public Health. 2022;10:848802.

Published In

Front Public Health

DOI

EISSN

2296-2565

Publication Date

2022

Volume

10

Start / End Page

848802

Location

Switzerland

Related Subject Headings

  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Female
  • Developing Countries
  • Antimicrobial Stewardship
  • Anti-Infective Agents
  • Anti-Bacterial Agents
  • Aged