Patterns of inpatient antibiotic use and antimicrobial resistance in the surgical wards of a Ugandan tertiary hospital: A mixed methods study.
Most surgical antibiotic prophylaxis in this Ugandan hospital lasted beyond recommended 24 hours.
Patterns of inpatient antibiotic use and antimicrobial resistance in the surgical wards of a Ugandan tertiary hospital: A mixed methods study.
Inappropriate antibiotic use in surgical wards is a major driver of antimicrobial resistance (antimicrobial resistance), especially in low- and middle-income countries, where empirical prescribing is common.
This study assessed inpatient antibiotic use and antimicrobial resistance patterns, integrating these findings with qualitative in-depth interviews (IDIs) which explored determinants of prescribing practices.
Quantitative data was collected through Point Prevalence Surveys (Point Prevalence Surveys) of antibiotic use and retrospective analysis of routine laboratory antimicrobial resistance data.
93.4% of surgical prophylaxis courses continued longer than the recommended first 24 hours.
Ceftriaxone 89/281 (31.7%) (95% CI: 26.27-37.46), metronidazole 66/281 (23.5%) (95% CI: 18.66-28.89) and levofloxacin 24/281 (8.5%) (95% CI: 11.61-20.44) were most prescribed antibiotic agents.
Watch category antibiotics were most used 152/281 (54.1%) (95%: 48.08-60.08), followed by Access category 129/281 (45.9%) (95% CI: 39.9-51.9).
Prolonged surgical antibiotic prophylaxis and Watch category predominant prescribing occur within a context of high antimicrobial resistance prevalence and constrained AMS infrastructure.
Integrated AMS interventions combining institutional antibiograms and their reinforcement, audit and feedback mechanisms, establishment of clear AMS structures and laboratory capacity strengthening are urgently needed to mitigate antimicrobial resistance and optimize surgical antibiotic use.