Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis

Objective This study assessed the trends and patterns of antimicrobial consumption (AMC) from 2020 to 2021, 2021–2022 and 2022–2023 at the Benjamin Mkapa Zonal Referral Hospital (BMH) in Dodoma, Tanzania.Design A retrospective cross-sectional study was conducted to collect AMC data for three financi...

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Main Authors: Moshi Moshi Shabani, Kauke Bakari Zimbwe, Yusto Julius Yona, Charity Alphonce Chiwambo, Alphonce Bilola Chandika, Humphrey Sawira Kiwelu
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/11/e083842.full
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author Moshi Moshi Shabani
Kauke Bakari Zimbwe
Yusto Julius Yona
Charity Alphonce Chiwambo
Alphonce Bilola Chandika
Humphrey Sawira Kiwelu
author_facet Moshi Moshi Shabani
Kauke Bakari Zimbwe
Yusto Julius Yona
Charity Alphonce Chiwambo
Alphonce Bilola Chandika
Humphrey Sawira Kiwelu
author_sort Moshi Moshi Shabani
collection DOAJ
description Objective This study assessed the trends and patterns of antimicrobial consumption (AMC) from 2020 to 2021, 2021–2022 and 2022–2023 at the Benjamin Mkapa Zonal Referral Hospital (BMH) in Dodoma, Tanzania.Design A retrospective cross-sectional study was conducted to collect AMC data for three financial years with respective denominators. The data were computed using the AMC Tool 2019 v1.9.0 and defined daily dose per 1000 inhabitants per day (DID).Setting The BMH, Dodoma, Tanzania.Participants This study surveyed quantities of antimicrobials procured at the BMH. It did not have any human participants.Outcome measures AMC was quantified in DID. The comparisons were made based on the DID of all surveyed antimicrobials, taking into account oral and parenteral administration and based on pharmacological classes. Further, DIDs were presented based on the 2023 WHO Access (A), Watch (W) and Reserve (R) (AWaRe) classification.Results In 29 assessed antimicrobials, the DIDs for 2020–2021, 2021–2022 and 2022–2023 were 3.0852, 3.5892 and 3.9213, respectively. The average DID per year was 3.5319, with a mean of 2.4207±1.9765 DID per year. The topmost consumed antimicrobials over the 3 years (doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitors, ampicillin/cloxacillin, amoxicillin/flucloxacillin, ceftriaxone, nitrofurantoin and clarithromycin) account over 90% of consumption. The most highly consumed therapeutic classes were beta-lactam antibacterial penicillins (34.71%), macrolides, lincosamides, streptogramins and others (25.75%), followed by tetracycline (23.88%). The AWaRe categorisation and antimicrobials not recommended (ANR) distribution were as follows: Access-51.61%, Watch-31.96%, Reserve-0.00%, and ANR-16.43%, respectively.Conclusion For every 1000 patients attending the BMH per day, our study found 2.4207±1.9765 DIDs of an antimicrobial were consumed. The most consumed antimicrobials include doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitor, ceftriaxone and metronidazole. To combat antimicrobial resistance effectively, it is imperative to institute a hospital policy for antimicrobial stewardship that prioritises the utilisation of a hospital formulary and antibiograms for the procurement of antimicrobials at the BMH.
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spelling doaj-art-cc8141c932c84b82af48257c43e318eb2024-11-14T05:15:09ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2023-083842Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysisMoshi Moshi Shabani0Kauke Bakari Zimbwe1Yusto Julius Yona2Charity Alphonce Chiwambo3Alphonce Bilola Chandika4Humphrey Sawira Kiwelu5Biomedical Research and Clinical Trials, Ifakara Health Institute, Bagamoyo, United Republic of TanzaniaOncology, Haematology and BMT Pharmacy Unit, Pharmacy and Compounding Section, Benjamin Mkapa Hospital, Dodoma, United Republic of TanzaniaOncology, Haematology and BMT Pharmacy Unit, Pharmacy and Compounding Section, Benjamin Mkapa Hospital, Dodoma, United Republic of TanzaniaDepartment of Pharmacy, The Aga Khan Hospital Trust, Dar es Salaam, United Republic of TanzaniaHospital Executive Committee, Benjamin Mkapa Hospital, Dodoma, United Republic of TanzaniaClinical Support, Benjamin Mkapa Hospital, Dodoma, United Republic of TanzaniaObjective This study assessed the trends and patterns of antimicrobial consumption (AMC) from 2020 to 2021, 2021–2022 and 2022–2023 at the Benjamin Mkapa Zonal Referral Hospital (BMH) in Dodoma, Tanzania.Design A retrospective cross-sectional study was conducted to collect AMC data for three financial years with respective denominators. The data were computed using the AMC Tool 2019 v1.9.0 and defined daily dose per 1000 inhabitants per day (DID).Setting The BMH, Dodoma, Tanzania.Participants This study surveyed quantities of antimicrobials procured at the BMH. It did not have any human participants.Outcome measures AMC was quantified in DID. The comparisons were made based on the DID of all surveyed antimicrobials, taking into account oral and parenteral administration and based on pharmacological classes. Further, DIDs were presented based on the 2023 WHO Access (A), Watch (W) and Reserve (R) (AWaRe) classification.Results In 29 assessed antimicrobials, the DIDs for 2020–2021, 2021–2022 and 2022–2023 were 3.0852, 3.5892 and 3.9213, respectively. The average DID per year was 3.5319, with a mean of 2.4207±1.9765 DID per year. The topmost consumed antimicrobials over the 3 years (doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitors, ampicillin/cloxacillin, amoxicillin/flucloxacillin, ceftriaxone, nitrofurantoin and clarithromycin) account over 90% of consumption. The most highly consumed therapeutic classes were beta-lactam antibacterial penicillins (34.71%), macrolides, lincosamides, streptogramins and others (25.75%), followed by tetracycline (23.88%). The AWaRe categorisation and antimicrobials not recommended (ANR) distribution were as follows: Access-51.61%, Watch-31.96%, Reserve-0.00%, and ANR-16.43%, respectively.Conclusion For every 1000 patients attending the BMH per day, our study found 2.4207±1.9765 DIDs of an antimicrobial were consumed. The most consumed antimicrobials include doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitor, ceftriaxone and metronidazole. To combat antimicrobial resistance effectively, it is imperative to institute a hospital policy for antimicrobial stewardship that prioritises the utilisation of a hospital formulary and antibiograms for the procurement of antimicrobials at the BMH.https://bmjopen.bmj.com/content/14/11/e083842.full
spellingShingle Moshi Moshi Shabani
Kauke Bakari Zimbwe
Yusto Julius Yona
Charity Alphonce Chiwambo
Alphonce Bilola Chandika
Humphrey Sawira Kiwelu
Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
BMJ Open
title Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
title_full Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
title_fullStr Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
title_full_unstemmed Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
title_short Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
title_sort trends and patterns of antimicrobial consumption at benjamin mkapa zonal referral hospital dodoma tanzania a cross sectional retrospective analysis
url https://bmjopen.bmj.com/content/14/11/e083842.full
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