Point Prevalence Survey on Antimicrobial Use in Pediatric Post-acute Care Facilities

Background. Antimicrobial resistance has not received the necessary attention it deserves in Africa. While many developed countries have successfully established antimicrobial stewardship programmes in hospital settings, several limited resource countries, including Ghana continue to struggle with getting stewardship programmes up and running. The Infection Prevention and Control team (IPC) and the Accident and Emergency Department (A&E) of the Komfo Anokye Teaching Hospital (KATH) in Ghana in a collaborative effort to pilot and establish an antimicrobial stewardship programme, conducted a baseline study with the aim of describing current practices in the A&E prior to the start of the programme. Methods. This study was conducted at the A&E Department of KATH, in Kumasi Ghana. Initially, all clinical staff of the Directorate were invited to participate in the survey to determine their practices in relation to antibiotic use. Patient folders were also reviewed 24 hours after admission to establish the frequency and pattern of antibiotic prescription in relation to the use of the microbiology investigations. Results. Of 75 staff members (including doctors, nurses and pharmacists) who responded to the survey, only 8% of the respondents were not directly involved in prescribing, dispensing or administering antibiotics. Majority (61.9%) of the respondents did not know about an existing antibiotic policy in the (A&E) department while 30.9% were not sure if one existed. Most (66.7%) of the respondents expressed worry about excessive antibiotic use and half (50.6%) of the respondents said antibiotics were being abused in the department. When asked directly, 49%(37/75) said there should be a change in the way antibiotics are used in the department. A review of patient’s folders showed that 141/894 patients (15.7%) had received antibiotics prior to admission and 477/894 (53.4%) of patients received antibiotics within 24 hours of admission in the A&E. Only 32% (110/343) were appropriately investigated microbiologically before antibiotics was started. Conclusion. This study reveals a high and inappropriate use of antibiotics. Urgent steps are needed to establish an antibiotic stewardship programme that will improve the appropriate use of antibiotics. Disclosures. All authors: No reported disclosures.