A retrospective analysis of paediatric inpatient data on antibiotic use in a teaching hospital in The Gambia

PS Chaw; KM Schlinkmann; H Raupach-Rosin; A Karch; J Huebner; R Mikolajczyk

doi:10.1055/s-0037-1605854

Das Gesundheitswesen, Table of Contents

Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605854

Vorträge

Georg Thieme Verlag KG Stuttgart · New York

A retrospective analysis of paediatric inpatient data on antibiotic use in a teaching hospital in The Gambia

PS Chaw

¹PhD Programme „Epidemiology“ Braunschweig-Hannover, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

²ESME – Epidemiological and Statistical Methods Research Group, Department of Epidemiology, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

³Institute for Medical Epidemiology, Biometry, and Informatics (IMEBI), Medical Faculty of the Martin-Luther University Halle-Wittenberg, Halle (Saale)

,

KM Schlinkmann

¹PhD Programme „Epidemiology“ Braunschweig-Hannover, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

²ESME – Epidemiological and Statistical Methods Research Group, Department of Epidemiology, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

,

H Raupach-Rosin

²ESME – Epidemiological and Statistical Methods Research Group, Department of Epidemiology, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

,

A Karch

¹PhD Programme „Epidemiology“ Braunschweig-Hannover, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

²ESME – Epidemiological and Statistical Methods Research Group, Department of Epidemiology, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

,

J Huebner

⁴Dr. Von Hauner Children's Hospital, Ludwig Maximilian University Munich, Division of Pediatric Infectious Diseases, Munich

,

R Mikolajczyk

¹PhD Programme „Epidemiology“ Braunschweig-Hannover, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

²ESME – Epidemiological and Statistical Methods Research Group, Department of Epidemiology, Helmholtz Centre for Infection Research, Epidemiology, Braunschweig

⁵Hannover Medical School, Hannover

³Institute for Medical Epidemiology, Biometry, and Informatics (IMEBI), Medical Faculty of the Martin-Luther University Halle-Wittenberg, Halle (Saale)

› Author Affiliations

Abstract

Full Text

Background:

Antibiotics are important in treating bacterial infections but resistance is a major problem and less well documented in developing countries. The aim of the study was to analyse antibiotic use in hospitalized children with respect to patients' diagnoses and microbiological testing.

Methods:

We conducted a retrospective analysis of paediatric inpatient data at The Edward Francis Small Teaching Hospital in Banjul, The Gambia. We used an access database to extract data from the admission folders of all patients (aged > 28 days to ≤15 years) admitted in 2015 (January-December), who received at least one antibiotic for 24 hours. We excluded records of patients who were discharged against medical advice and admission folders with inappropriate dating or loss of documents containing antibiotic and/or diagnosis details.

Results:

Over half of the admitted patients received at least one antibiotic during hospital stay (497/917). Ampicillin was the most commonly used antibiotic (38% (188/497)), and resistance against ampicillin was most common among the resistant isolates (23% (9/39)). Pneumonia was the most common diagnosis on admission among these patients that received antibiotics (20% (100/497)). Of the total test specimens on admission (50% (248/497)), 67% (165/248) had no documented results, 24% (59/248) showed no growth, the remaining 10% (24/248) were positive. Among these, Klebsiella sp. were the most often isolated organism (33% (8/24)) and had the highest reported antibiotic resistance (49% (19/39)).

Conclusion:

There was a significant proportion of the patients who received antibiotics, with deficiencies in microbiological tests. Antibiotic resistance was highest for the most commonly used antibiotics. More specific studies on the resistance profile of the commonly isolated organisms would be useful epidemiologically and in helping to decide on rational antibiotic use.

KEY WORDS: Paediatrics, antibiotics, microbiology tests, resistance.