Point Prevalence Surveys of Antibiotic Prescribing in Children at a Tertiary Hospital in a resource constraint, low- income sub-Saharan African country.

Background: Antibiotic resistance has been widely described in children by various pathogens to multiple antibiotics, these have become a global health crisis and an emergency. Factors associated with antibiotic use are both community and hospital based as studies have reported increased use of antibiotics by parents and caregivers as well as health care providers This study aimed to describe prevalence rates of antibiotic prescribing and evaluate antibiotic prescribing practices as well as targets for improving the quality of antimicrobial prescribing in children over time. Method Point prevalence survey of antimicrobial use was performed yearly for 4 years to monitor trends in antimicrobial prescribing., Data from all patients admitted before 8 am on the day of the PPS were included. A web-based application designed by the University of Antwerp was used for data-entry, validation and analysis (http://www.global-pps.com). Results A total of 260 children including 90 (34.6%) neonates and 170 (65.4%) older children were admitted during the four surveys. Overall, 179 (68.8%) patients received at least one antibiotic. In neonates, the prevalence of antibiotic use increased from 78.9–89.5% but reduced from 100–58.8% in older children. There was a reduction in the use of antibiotics for prophylaxis from 45.7–24.6%. The most frequently prescribed antibiotic groups were third generation cephalosporins and aminoglycosides. The most common indication for antibiotic prescribing was sepsis in neonates and central nervous system infection in older children. The documentation of reason in notes increased from 33–100% while stop review date also increased from 19.4–82.1%. Conclusion The prevalence of antibiotic use was high with cephalosporins being the most prescribed antibiotic.