The use of antibiotics at two paediatric wards at

Abstract

Master Thesis, Programme in medicine. TITLE: The use of antibiotics at two paediatric wards at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. AUTHOR: Sandra Wojt. 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.