The use of antibiotics at two paediatric wards at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania

Citation: 
Sandra Wojt
Publication year: 
2016

Background

Antibiotic resistance is an increasing problem worldwide. Multiple studies report of high 

resistance rates in Tanzania. There are several factors contributing to antibiotic resistance 

including overuse and lack of surveillance systems. There is a need to monitor the actual 

usage of antibiotics in the health care systems in order to improve this and to combat the 

antibiotic resistance.

Objectives

The objective of this study was to describe the usage of antibiotics among hospitalized 

children and to which extent diagnostic measurements were used, such as cultures, and also to 

describe the most common isolates found from cultures and its susceptibility patterns.

Methods

A cross-sectional study conducted during October-November 2013 at Kilimanjaro Christian 

Medical Centre (KCMC) in Moshi, Tanzania. All children admitted to the neonatal ward and 

the general paediatrics ward were enrolled. Information was collected from medical files 

using a standardized protocol

Results

Among 201 patients admitted, 72 % were inserted on antibiotics on the day of admission. The 

most common antibiotics were Ampicillin and Gentamycin; these were used in 44 % and 42 

% of all antibiotic therapies respectively. Specimens were taken for culture 29 times, 34 % of 

these yielded bacterial isolates. The most common isolate was Coagulase negative 

Staphylococci (n=3) followed by S. aureus (n=2). One isolate, Pseudomonas, was found 

resistant to Gentamycin. In 53 % of the cultures ordered no results were found. Among 

febrile patients, specimens were taken for culture in 37 % of cases.

Conclusion

There is a high usage of antibiotics at the paediatric wards at KCMC but this is also a referral 

hospital with many ill patients. The choice of therapy for the most common indications; 

respiratory illness and septicaemia mostly follow the local guidelines. Cultures are often 

ordered, but in more than half of them results are missing. There is a need to go over the 

routines to find out the reason for this and to increase the rates of cultures, especially among 

febrile patients.