1. Use of WATCH antibiotics prior to presentation to the hospital in rural Burkina Faso
- Author
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Daniel VALIA, Brecht Ingelbeen, Bérenger Kaboré, Ibrahima Karama, Marjan Peeters, Palpouguini Lompo, Erika Vlieghe, Annelies Post, Janneke Cox, Quirijn de Mast, Annie Robert, Marianne A.B. van der Sande, Hector Rodriguez Villalobos, Andre van der Ven, Halidou Tinto, Jan Jacobs, Rodriguez-Villalobos, Hector/0000-0003-3041-1591, VALIA, Daniel/0000-0003-0851-9352, Ingelbeen, Brecht/0000-0002-2214-6858, Valia, Daniel, Ingelbeen, Brecht, Kabore, Berenger, Karama, Ibrahima, Peeters, Marjan, Lompo, Palpouguini, Vlieghe, Erika, Post, Annelies, COX, Janneke, de Mast, Quirijn, Robert, Annie, van der Sande, Marianne A. B., Villalobos, Hector Rodriguez, van der Ven, Andre, Tinto, Halidou, Jacobs, Jan, UCL - SSS/IREC/MBLG - Pôle de Microbiologie médicale, UCL - (SLuc) Service de microbiologie, and UCL - SSS/IREC/EPID - Pôle d'épidémiologie et biostatistique
- Subjects
Microbiology (medical) ,Adolescent ,Antimicrobial resistance ,Microbiology ,Antimicrobial Stewardship ,All institutes and research themes of the Radboud University Medical Center ,Burkina Faso ,Humans ,Pharmacology (medical) ,Community antibiotic use ,AWaRe ,Pharmacology & Pharmacy ,Child ,Biology ,Public, Environmental & Occupational Health ,Science & Technology ,Pharmacology. Therapy ,Environmental and Occupational Health ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Hospitals ,Anti-Bacterial Agents ,Infectious Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Child, Preschool ,Health Facilities ,Public Health ,Human medicine ,Life Sciences & Biomedicine - Abstract
BackgroundIn low- and middle-income countries, the prevalence of antimicrobial resistance (AMR) is increasing. To control AMR, WHO recommends monitoring antibiotic use, in particular Watch antibiotics. These are critically important antibiotics, with restricted use because at risk of becoming ineffective due to increasing AMR. We investigated pre-hospital antibiotic use in rural Burkina Faso.MethodsDuring 2016–2017, we collected data from patients aged > 3 months presenting with severe acute fever to the rural hospital of Nanoro Health District, Burkina Faso, including antibiotic use in the two weeks prior to consultation or hospitalization. We analysed reported antibiotic use by applying the WHO Access, Watch, Reserve classification.ResultsOf 920 febrile participants (63.0% ≤ 14 years), pre-hospital antibiotic use was reported by 363 (39.5%). Among these 363, microbiological diagnoses were available for 275 (75.8%) patients, of whom 162 (58.9%) were non-bacterial infections. Use of more than one antibiotic was reported by 58/363 (16.0%) participants. Of 491 self-referred patients who did not previously visit a primary health care center, 131 (26.7%) reported antibiotic use. Of 424 antibiotics reported, 265 (62.5%) were Access and 159 (37.5%) Watch antibiotics. Watch antibiotic use was more frequent among patients > 14 year olds (51.1%) compared to those 0–14 year old (30.7%,p p = 0.004). Most frequently reported Watch antibiotics were ceftriaxone (114, 71.7%) and ciprofloxacin (32, 20.1%).ConclusionThe reported frequent use of Watch group antibiotics among febrile patients prior to presentation to the hospital in rural Burkina Faso highlights the need to develop targeted interventions to improve antibiotic use in community settings as part of strengthening antibiotic stewardship in low- and middle-income countries. This should include facilitating referral, access to qualified prescribers and diagnostic tools in rural primary health care centers.Trial registrationClinicalTrials.gov identifier: NCT02669823. Registration date was February 1, 2016.
- Published
- 2022