Point Prevalence Survey of Antibiotic Use across 13 Hospitals in Uganda

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial resistance (AMR) is a global health threat requiring effective antimicrobial stewardship.
• Standardized monitoring of antibiotic use is crucial for successful stewardship interventions.
• Limited data exists on hospital antibiotic use patterns in Uganda.

Purpose of the Study:

• To assess antibiotic utilization in Ugandan hospitals using the WHO's standardized point prevalence survey methodology.
• To identify gaps in antibiotic prescribing practices and evaluate compliance with national guidelines.
• To classify antibiotic use according to the WHO Access, Watch, and Reserve (AWaRe) classification.

Main Methods:

• A point prevalence survey was conducted in 13 public and private not-for-profit hospitals in Uganda.
• Data on 1077 patients and 1387 antibiotic prescriptions were collected between December 2020 and April 2021.
• Analysis included antibiotic use characteristics, prevalence, guideline compliance, and AWaRe classification.

Main Results:

• 74% of surveyed patients were prescribed at least one antibiotic.
• Compliance with Uganda Clinical Guidelines was low at 30%.
• Watch-classified antibiotics accounted for 44% of prescriptions, with ceftriaxone being the most frequent (37%).

Conclusions:

• Significant improvements in antimicrobial stewardship are needed in Uganda.
• High utilization of Watch-category antibiotics, particularly ceftriaxone, highlights a key area for intervention.
• This study provides essential benchmarks for future antimicrobial stewardship evaluations in the region.