The use of antibiotics in the university hospitals of Conakry: evaluation of the consumption and the analysis of determinants

Abstract

INTRODUCTION The inappropriate use of drugs is a major concern of public health programs. Globally, over 50% of all medicines are prescribed, distributed or sold inappropriately and more than 50% of countries do not implement the basic policies to promote the rational use of medicines. 1 In developing countries, less than 40% of patients in the public sector and less than 30% in the private sector are treated according to clinical guidelines. 2 Among the current problems related to irrational drug use appears the overuse of antibiotics. 2 Indeed, antibiotics are among the drugs most frequently prescribed to the hospitalized patients. Studies indicate that nearly a third of all of the hospitalized patients receive antimicrobial ABSTRACT Background: The main objectives of this study were to evaluate the use of antibiotics; assess the knowledge and perception of prescribers regarding the use of antibiotics; to describe the policy on the use of antibiotics and to identify factors associated with high antibiotic consumption at the University Hospital of Conakry. Methods: This study has two components: a retrospective study covering three months' consumption of antibiotics (From January 2013 to March 2013), and a cross-sectional study on both the knowledge and perception of prescribers concerning the use of antibiotics and the policies on their proper use. Results: Of a total of 1,199 cases examined at the University Hospital of Conakry, 953 patients received at least one antibiotic about 79.5% of the total cases. The total amount consumed was 55.3 DDD / 100 BD. The class of the Extended-spectrum penicillin's was widely the most used at 22.9 DDD / 100 BD. The median knowledge score of prescribers; valued at a total of 8, was equal to 5. The Composite Index for proper use of Antibiotic (CIATB) was 2.25 / 20. Determinants or factors associated with the large use of antibiotics were the hospital site, the ward and the average length of stay. Conclusion: Based on the results of our study, it appears that lot antibiotics are largely consumed at the University Hospital of Conakry; and that consumption are influenced by the hospital site, the ward and the length of stay. This study reveals also the absence of any policy of the rational use of antibiotics. Therefore, the study illustrates the need for the implementation of an antimicrobial stewardship action.