Prevalence of Antibiotics Prescribed by Doctors in Medical Emergencies in a Tertiary Hospital, Burkina Faso

Abstract

Background: The prescription of antibiotics in these departments must be the result of medical reasoning leading to a strong clinical suspicion of bacterial infection. Emergency antibiotic therapy is a key factor in the fight against antimicrobial resistance. Many countries have set up national action plans to combat antimicrobial resistance (AMR), in which the proper use of antimicrobials is a key priority. Aims: The present study aims to assess the quality of antibiotic prescribing in medical emergencies in order to improve their use in health facilities in a medical emergency department of the Gaoua Regional Hospital Centre. Methodology: This was a prospective, descriptive, observational study conducted, from April 1 to May 31, 2021, on the initial prescription of antibiotics, verifying its compliance with the antibiotic therapy reference in Burkina Faso. Patients for whom antibiotic therapy was prescribed and administered in the emergency department were included in the study. The study population comprised patients over 15 years of age, admitted to the Gaoua Medical Emergency Department and receiving one or more antibiotics in the department, and clinicians who prescribed antibiotics during the study period. Qualitative variables were reported as counts and frequencies, and quantitative variables as means (standard deviation). Results: During our study period, 181 out of 382 patients admitted to the emergency department were included. The frequency of antibiotic prescription was 47.38%, the population was predominantly male (63.54%) with an average age of 45.59 years. On admission, 43.85% of patients received antibiotics, 56.63% of them as mono-antibiotics and 37.35% as bi-antibiotics. Betalactam antibiotics were the most widely prescribed family of antibiotics. Ninety-two microbiological samples were taken, including 44 patients for coproculture, 31 patients for urine cytobacteriological examination (UCE), 10 patients for cerebrospinal fluid UCE and 7 blood cultures. For 09 patients, the results were adapted to the antibiotic susceptibility test. In the majority (71.30%) of cases, antibiotic therapy had a good indication but did not comply with Burkina Faso's national health directives (73.49% of prescriptions). Eighty percent of staff referred to hyperleukocytosis to institute antibiotic therapy. Conclusion: This study shows a high level of antibiotic prescribing in Gaoua's medical emergencies. Only a quarter of antibiotic prescriptions were appropriate according to Burkina Faso standards. Ongoing training activities and wide distribution of the prescription guide will help improve the quality of antibiotic prescribing.