Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented

Nikki D’Arcy 1,Diane Ashiru-Oredope 1,*ORCID,Omotayo Olaoye 1,Daniel Afriyie 2ORCID,Zainab Akello 3,Daniel Ankrah 4ORCID,Derrick Mawuena Asima 5,David C. Banda 6,Scott Barrett 7,Claire Brandish 8,Joseph Brayson 7,Peter Benedict 9,Cornelius C. Dodoo 10ORCID,Frances Garraghan 11,Josephyn Hoyelah, Sr. 12,Yogini Jani 13ORCID,Freddy Eric Kitutu 14,Ismail Musoke Kizito 15,Appiah-Korang Labi 16,Mariyam Mirfenderesky 17,Sudaxshina Murdan 18ORCID,Caoimhe Murray 19,Noah Obeng-Nkrumah 20,William J’Pathim Olum 21,Japheth Awuletey Opintan 16,Edwin Panford-Quainoo 22ORCID,Ines Pauwels 23ORCID,Israel Sefah 24ORCID,Jacqueline Sneddon 25,Anja St. Clair Jones 26 andAnn Versporten 2
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Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base.