PDF(Pubmed)
Abstract：
There is paucity of data describing the rate and quality indices of antibiotics used among hospitalized patients at continental level in Africa. This systematic review evaluated the pooled prevalence, indications, and types of antibiotics used in hospitals across Africa.
Three electronic databases, PubMed, Scopus, and African Journals Online (AJOL), were searched using search terms. Point prevalence studies of antibiotic use in inpatient settings published in English language from January 2010 to November 2022 were considered for selection. Additional articles were identified by checking the reference list of selected articles.
Of the 7254 articles identified from the databases, 28 eligible articles involving 28 studies were selected. Most of the studies were from Nigeria (n = 9), Ghana (n = 6), and Kenya (n = 4). Overall, the prevalence of antibiotic use among hospitalized patients ranged from 27.6 to 83.5% with higher prevalence in West Africa (51.4-83.5%) and North Africa (79.1%) compared to East Africa (27.6-73.7%) and South Africa (33.6-49.7%). The ICU (64.4-100%; n = 9 studies) and the pediatric medical ward (10.6-94.6%; n = 13 studies) had the highest prevalence of antibiotic use. Community-acquired infections (27.7-61.0%; n = 19 studies) and surgical antibiotic prophylaxis (SAP) (14.6-45.3%; n = 17 studies) were the most common indications for antibiotic use. The duration of SAP was more than 1 day in 66.7 to 100% of the cases. The most commonly prescribed antibiotics included ceftriaxone (7.4-51.7%; n = 14 studies), metronidazole (14.6-44.8%; n = 12 studies), gentamicin (n = 8 studies; range: 6.6-22.3%), and ampicillin (n = 6 studies; range: 6.0-29.2%). The access, watch, and reserved group of antibiotics accounted for 46.3-97.9%, 1.8-53.5%, and 0.0-5.0% of antibiotic prescriptions, respectively. The documentation of the reason for antibiotic prescription and date for stop/review ranged from 37.3 to 100% and 19.6 to 100%, respectively.
The point prevalence of antibiotic use among hospitalized patients in Africa is relatively high and varied between the regions in the continent. The prevalence was higher in the ICU and pediatric medical ward compared to the other wards. Antibiotics were most commonly prescribed for community-acquired infections and for SAP with ceftriaxone, metronidazole, and gentamicin being the most common antibiotics prescribed. Antibiotic stewardship is recommended to address excessive use of SAP and to reduce high rate of antibiotic prescribing in the ICU and pediatric ward.
Three electronic databases, PubMed, Scopus, and African Journals Online (AJOL), were searched using search terms. Point prevalence studies of antibiotic use in inpatient settings published in English language from January 2010 to November 2022 were considered for selection. Additional articles were identified by checking the reference list of selected articles.
Of the 7254 articles identified from the databases, 28 eligible articles involving 28 studies were selected. Most of the studies were from Nigeria (n = 9), Ghana (n = 6), and Kenya (n = 4). Overall, the prevalence of antibiotic use among hospitalized patients ranged from 27.6 to 83.5% with higher prevalence in West Africa (51.4-83.5%) and North Africa (79.1%) compared to East Africa (27.6-73.7%) and South Africa (33.6-49.7%). The ICU (64.4-100%; n = 9 studies) and the pediatric medical ward (10.6-94.6%; n = 13 studies) had the highest prevalence of antibiotic use. Community-acquired infections (27.7-61.0%; n = 19 studies) and surgical antibiotic prophylaxis (SAP) (14.6-45.3%; n = 17 studies) were the most common indications for antibiotic use. The duration of SAP was more than 1 day in 66.7 to 100% of the cases. The most commonly prescribed antibiotics included ceftriaxone (7.4-51.7%; n = 14 studies), metronidazole (14.6-44.8%; n = 12 studies), gentamicin (n = 8 studies; range: 6.6-22.3%), and ampicillin (n = 6 studies; range: 6.0-29.2%). The access, watch, and reserved group of antibiotics accounted for 46.3-97.9%, 1.8-53.5%, and 0.0-5.0% of antibiotic prescriptions, respectively. The documentation of the reason for antibiotic prescription and date for stop/review ranged from 37.3 to 100% and 19.6 to 100%, respectively.
The point prevalence of antibiotic use among hospitalized patients in Africa is relatively high and varied between the regions in the continent. The prevalence was higher in the ICU and pediatric medical ward compared to the other wards. Antibiotics were most commonly prescribed for community-acquired infections and for SAP with ceftriaxone, metronidazole, and gentamicin being the most common antibiotics prescribed. Antibiotic stewardship is recommended to address excessive use of SAP and to reduce high rate of antibiotic prescribing in the ICU and pediatric ward.
摘要：
背景：描述非洲大陆住院患者抗生素使用率和质量指数的数据很少。这项系统评价评估了合并的患病率，适应症,以及非洲各地医院使用的抗生素类型。
方法：三个电子数据库，PubMed,Scopus,和非洲期刊在线（AJOL），使用搜索词进行搜索。考虑选择2010年1月至2022年11月以英文发表的住院患者抗生素使用点患病率研究。通过检查选定文章的参考列表确定了其他文章。
结果：在从数据库中确定的7254篇文章中，选择了28篇符合条件的文章，涉及28项研究。大多数研究来自尼日利亚（n=9），加纳（n=6），肯尼亚（n=4）。总的来说,住院患者使用抗生素的患病率为27.6~83.5%,西非(51.4~83.5%)和北非(79.1%)的患病率高于东非(27.6~73.7%)和南非(33.6~49.7%).ICU（64.4-100％；n=9项研究）和儿科病房（10.6-94.6％；n=13项研究）的抗生素使用率最高。社区获得性感染（27.7-61.0％；n=19项研究）和外科抗生素预防（SAP）（14.6-45.3％；n=17项研究）是最常见的抗生素使用适应症。在66.7至100％的病例中，SAP的持续时间超过1天。最常用的抗生素包括头孢曲松（7.4-51.7％；n=14项研究），甲硝唑（14.6-44.8％；n=12项研究），庆大霉素（n=8项研究；范围：6.6-22.3％），和氨苄青霉素（n=6项研究；范围：6.0-29.2%）。访问，watch,保留组抗生素占46.3-97.9%，1.8-53.5%，和0.0-5.0%的抗生素处方，分别。抗生素处方的原因和停止/审查日期的文件范围为37.3%至100%和19.6%至100%，分别。
结论：非洲住院患者中抗生素使用的点患病率相对较高，并且在非洲大陆的地区之间存在差异。与其他病房相比，ICU和儿科病房的患病率更高。抗生素最常用于社区获得性感染和头孢曲松治疗SAP，甲硝唑,庆大霉素是最常见的抗生素。建议使用抗生素管理来解决SAP的过度使用，并减少ICU和儿科病房中抗生素处方的高比率。
方法：三个电子数据库，PubMed,Scopus,和非洲期刊在线（AJOL），使用搜索词进行搜索。考虑选择2010年1月至2022年11月以英文发表的住院患者抗生素使用点患病率研究。通过检查选定文章的参考列表确定了其他文章。
结果：在从数据库中确定的7254篇文章中，选择了28篇符合条件的文章，涉及28项研究。大多数研究来自尼日利亚（n=9），加纳（n=6），肯尼亚（n=4）。总的来说,住院患者使用抗生素的患病率为27.6~83.5%,西非(51.4~83.5%)和北非(79.1%)的患病率高于东非(27.6~73.7%)和南非(33.6~49.7%).ICU（64.4-100％；n=9项研究）和儿科病房（10.6-94.6％；n=13项研究）的抗生素使用率最高。社区获得性感染（27.7-61.0％；n=19项研究）和外科抗生素预防（SAP）（14.6-45.3％；n=17项研究）是最常见的抗生素使用适应症。在66.7至100％的病例中，SAP的持续时间超过1天。最常用的抗生素包括头孢曲松（7.4-51.7％；n=14项研究），甲硝唑（14.6-44.8％；n=12项研究），庆大霉素（n=8项研究；范围：6.6-22.3％），和氨苄青霉素（n=6项研究；范围：6.0-29.2%）。访问，watch,保留组抗生素占46.3-97.9%，1.8-53.5%，和0.0-5.0%的抗生素处方，分别。抗生素处方的原因和停止/审查日期的文件范围为37.3%至100%和19.6%至100%，分别。
结论：非洲住院患者中抗生素使用的点患病率相对较高，并且在非洲大陆的地区之间存在差异。与其他病房相比，ICU和儿科病房的患病率更高。抗生素最常用于社区获得性感染和头孢曲松治疗SAP，甲硝唑,庆大霉素是最常见的抗生素。建议使用抗生素管理来解决SAP的过度使用，并减少ICU和儿科病房中抗生素处方的高比率。
