Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey
Summary: Background: Antimicrobial resistance (AMR) is a significant global health concern, with improper antibiotic use contributing to its rise. Tanzania initiated an AMR action plan in 2017, but comprehensive surveillance and stewardship efforts remain limited. This study focused on evaluating a...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | Infection Prevention in Practice |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590088924000933 |
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| author | T.J. Schrama K.J. Vliegenthart-Jongbloed M. Gemuwang E.Q. Nuwass |
| author_facet | T.J. Schrama K.J. Vliegenthart-Jongbloed M. Gemuwang E.Q. Nuwass |
| author_sort | T.J. Schrama |
| collection | DOAJ |
| description | Summary: Background: Antimicrobial resistance (AMR) is a significant global health concern, with improper antibiotic use contributing to its rise. Tanzania initiated an AMR action plan in 2017, but comprehensive surveillance and stewardship efforts remain limited. This study focused on evaluating antibiotic use, particularly surgical prophylaxis, in a rural Tanzanian hospital. Methods: The study was conducted at Haydom Lutheran Hospital in Tanzania in May 2023, using a cross-sectional point prevalence survey. Antibiotic use in all patients admitted for >24 h and those undergoing surgery was recorded, including type, dose, indication and duration. Quality indicators for surgical prophylaxis were assessed. Results: Among 199 inpatients, 55% received antibiotics, with surgical prophylaxis accounting for 23% of prescriptions. Notably, none of the patients who received surgical prophylaxis received a single-dose regimen, and 67% exceeded the recommended 24-h duration. A combination of ampicillin-cloxacillin plus metronidazole was the most commonly prescribed combination for surgical prophylaxis (41% of prescriptions). Thirty-three percent of the antibiotics prescribed for surgical prophylaxis were classified as ‘Not recommended’ by the World Health Organization. Furthermore, 90% of surgical prophylaxis prescriptions lacked documented rationale, and 83% of prescriptions lacked stop/review dates in medical records. Conclusion: This study reveals a high prevalence of prolonged antibiotic use for surgical prophylaxis, frequent use of antibiotics classified as ‘Not recommended’, and a lack of adequate documentation, which deviates from international standards. These practices highlight the urgent need for contextualized national guidelines, large-scale implementation projects of evidence-based interventions, and local initiatives in antibiotic stewardship, particularly in low-resource settings. |
| format | Article |
| id | doaj-art-218a2ec80011484fa7ea6f9cedd13947 |
| institution | DOAJ |
| issn | 2590-0889 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Infection Prevention in Practice |
| spelling | doaj-art-218a2ec80011484fa7ea6f9cedd139472025-08-20T03:00:50ZengElsevierInfection Prevention in Practice2590-08892025-03-017110042910.1016/j.infpip.2024.100429Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence surveyT.J. Schrama0K.J. Vliegenthart-Jongbloed1M. Gemuwang2E.Q. Nuwass3Erasmus University Medical Centre, Department of Internal Medicine, Infectious Diseases Section, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The NetherlandsErasmus University Medical Centre, Department of Internal Medicine, Infectious Diseases Section, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands; Haydom Lutheran Hospital, Haydom, United Republic of Tanzania; Corresponding author. Address: Erasmus University Medical Centre, Department of Internal Medicine, Infectious Diseases Section, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.Haydom Lutheran Hospital, Haydom, United Republic of TanzaniaHaydom Lutheran Hospital, Haydom, United Republic of TanzaniaSummary: Background: Antimicrobial resistance (AMR) is a significant global health concern, with improper antibiotic use contributing to its rise. Tanzania initiated an AMR action plan in 2017, but comprehensive surveillance and stewardship efforts remain limited. This study focused on evaluating antibiotic use, particularly surgical prophylaxis, in a rural Tanzanian hospital. Methods: The study was conducted at Haydom Lutheran Hospital in Tanzania in May 2023, using a cross-sectional point prevalence survey. Antibiotic use in all patients admitted for >24 h and those undergoing surgery was recorded, including type, dose, indication and duration. Quality indicators for surgical prophylaxis were assessed. Results: Among 199 inpatients, 55% received antibiotics, with surgical prophylaxis accounting for 23% of prescriptions. Notably, none of the patients who received surgical prophylaxis received a single-dose regimen, and 67% exceeded the recommended 24-h duration. A combination of ampicillin-cloxacillin plus metronidazole was the most commonly prescribed combination for surgical prophylaxis (41% of prescriptions). Thirty-three percent of the antibiotics prescribed for surgical prophylaxis were classified as ‘Not recommended’ by the World Health Organization. Furthermore, 90% of surgical prophylaxis prescriptions lacked documented rationale, and 83% of prescriptions lacked stop/review dates in medical records. Conclusion: This study reveals a high prevalence of prolonged antibiotic use for surgical prophylaxis, frequent use of antibiotics classified as ‘Not recommended’, and a lack of adequate documentation, which deviates from international standards. These practices highlight the urgent need for contextualized national guidelines, large-scale implementation projects of evidence-based interventions, and local initiatives in antibiotic stewardship, particularly in low-resource settings.http://www.sciencedirect.com/science/article/pii/S2590088924000933Antibiotic prophylaxisSurgical prophylaxisPrevention and controlDrug therapyAntimicrobial stewardshipPrescription |
| spellingShingle | T.J. Schrama K.J. Vliegenthart-Jongbloed M. Gemuwang E.Q. Nuwass Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey Infection Prevention in Practice Antibiotic prophylaxis Surgical prophylaxis Prevention and control Drug therapy Antimicrobial stewardship Prescription |
| title | Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey |
| title_full | Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey |
| title_fullStr | Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey |
| title_full_unstemmed | Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey |
| title_short | Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey |
| title_sort | surgical prophylaxis in haydom lutheran hospital tanzania learning from a point prevalence survey |
| topic | Antibiotic prophylaxis Surgical prophylaxis Prevention and control Drug therapy Antimicrobial stewardship Prescription |
| url | http://www.sciencedirect.com/science/article/pii/S2590088924000933 |
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