Prevalence and predictors of prior antibacterial use among patients presenting to hospitals in Northern Uganda

BMC Clinical Pharmacology

Celestino Obua¹  Jasper Ogwal-Okeng⁴  Esther Atukwase⁵  Hannington Baluku³  Yukari C. Manabe²  Moses Ocan¹ 

[1] Department of Pharmacology & Therapeutics, Makerere University, Kampala, Uganda;Division of Infectious Diseases Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA;Department of Clinical Microbiology, Makerere University, Kampala, Uganda;Faculty of medicine, Gulu University, Gulu, Uganda;Mild may Uganda, Kampala, Uganda

关键词: Northern Uganda;    Self-medication;    Self-report;    Urine antibacterial bioassay;    Antibacterial;   

Others  :  1228273
DOI  :  10.1186/s40360-015-0027-8

 received in 2015-05-20, accepted in 2015-09-22,  发布年份 2015

【 摘 要 】

Background

Human antibacterial exposure occur in different ways including consumption of animal and agricultural products as well as use of prescribed and non-prescribed agents. We estimated the prevalence and explored the predictors of antibacterial use among patients presenting to hospitals in northern Uganda.

Methods

Four hundred fifty (450) patients were randomly selected and antibacterial use prior to hospital visit measured using a questionnaire and urine antibacterial activity assay. Urine antibacterial bioassays were performed using American type culture collections of Escherichia coli, Bacillus subtilis and Streptococcus pyogenes. Data were analysed using STATA 12.0 at 95 % confidence level.

Results

Of 450 patients interviewed, 62.2 % had used antibacterial agents. Urine antibacterial activity was detected in 30.4 % of the samples tested. Of the 85 patients who reported not taking any antibacterial at home, 16 (18.8 %) had urine with antibacterial activity. Most test bacteria, E. coli (74.5 %), B. subtilis (72.6 %) and S. pyogens (86.7 %) were sensitive to urine of patients who reported using antibacterial drugs before hospital visit. From the interview, metronidazole 15.6 % (70/450), amoxicillin 12 % (54/450), and ciprofloxacin 10.4 % (47/450) were the most used antibacterial agents. Patient age (OR, 2.45: 95 % CI: 1.02–5.91: P = 0.024), time-lag between last drug intake and hospital visit (OR: 3.18: 95 % CI: 1.44–7.0: P < 0.0001), and time-lag between illness onset and hospital visit (OR: 1.89: 95 % CI: 0.38–5.1: P = 0.027) predicted the use of antibacterial agents before hospital visit.

Discussion

Community antibacterial use continues to take place in an unregulated manner. In addition, physiciansrarely seek to ascertain prior use of antibacterial agents among patients presenting to hospitals. This couldhave a bearing on patient treatment outcomes.

Conclusion

Knowledge of prior antibacterial use among patients presenting to hospitals is useful to physicians in ensuring antibacterial stewardship.

【 授权许可】

   
2015 Ocan et al.

【 图 表 】

Fig. 1.

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