Point prevalence of antibiotic use in teaching hospitals in Tunisia

Improving the rational use of antibiotics is critical to limiting the development and spread of antimicrobial resistance.

To assess the prevalence and types of antibiotic use and the association with patient characteristics in 2 teaching hospitals in Tunisia.

Using a modified WHO point prevalence survey protocol, we collected data on the prevalence of antibiotics use and types and classes of antibiotic used from the medical records of 1028 patients hospitalized at the medical, surgical and intensive care units of 2 teaching hospitals in Sfax Governorate, Tunisia. We analysed the data using SPSS version 26. P ≤ 0.05 was considered statistically significant.

The prevalence of antibiotic use was 26.8%, with an average of 1.7 antibiotics used per patient. Of the 466 antibiotic types used, 156 (35.4%) belonged to the access group and 277 (59.4%) to the watch group. Antibiotic use was highest (39.8%) among children aged <5 years and males had 30% higher chances of receiving antibiotics. Antibiotic use was higher among patients in high-risk wards than those in non-high-risk wards and among patients in intensive care units than in nonintensive care units. We found that 79.2% of the antibiotics were used empirically; watch antibiotics were used empirically in 78.7% of the patients.

The frequent use of watch group antibiotics for empirical treatment and the significantly higher antibiotic use among children and the elderly indicate the need to re-assess prescription practices in these and other hospitals, enhance prescription education, and develop standard guidelines for optimising antibiotic use in Tunisia.