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Point Prevalence Survey of Antibiotic Use in Level 1 hospitals in Zambia: Future Prospects for Antimicrobial Stewardship Programs

Mudenda S 1 , Lubanga AF 2 , Jamshed S 3 , Biemba B 1 , Sakala R 1 , Chiyabi M 1 Show all authors , Kavubya L 1 , Milambo LT 1 , Bumbangi FN 4 , Chizimu JY 5 , Yamba K 6 , Wesangula E 7 , Chigome A 8 , Kalungia AC 1 , Sefah IA 9 , Mustafa ZUI 10 , Massele AY 11 , Saleem Z 12 , Mutemwa R 13 , Kazonga E 13 , Sartelli M 14 , Meyer JC 8 , Muma JB 15 , Chilengi R 5 , Godman B 8

Affiliations 

  • 1 Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
  • 2 Education and Research, Clinical Research Education and Management Services (CREAMS), Lilongwe, Malawi
  • 3 Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
  • 4 Department of Medicine and Clinical Sciences, School of Medicine, Eden University, Lusaka, Zambia
  • 5 Antimicrobial Resistance Coordinating Committee, Zambia National Public Health Institute, Lusaka, Zambia
  • 6 Action on Antibiotic Resistance (React) Africa, Lusaka, Zambia
  • 7 Strengthening Pandemic Preparedness, Eastern, Central, and Southern Africa Health Community, Arusha, Tanzania
  • 8 Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa
  • 9 Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Ghana
  • 10 Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, Malaysia
  • 11 Department of Clinical Pharmacology and Therapeutics, Kairuki University, Dar Es Salaam, Tanzania
  • 12 Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
  • 13 Department of Public Health, School of Medicine and Health Sciences, University of Lusaka, Lusaka, Zambia
  • 14 Department of Surgery, Macerata Hospital, Macerata, Italy
  • 15 Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
Infect Drug Resist, 2025;18:887-902.
PMID: 39975588 DOI: 10.2147/IDR.S509522

Abstract

INTRODUCTION: The inappropriate prescribing and use of antibiotics have contributed to the emergence and spread of antimicrobial resistance (AMR). In Zambia, there is a paucity of information on the prescribing patterns and use of antibiotics among hospitalized patients in level 1 hospitals. This study investigated antibiotic use in five level 1 hospitals in Lusaka, Zambia.

METHODS: This cross-sectional study utilized the World Health Organization (WHO) Point Prevalence Survey (PPS) methodology among in-patients admitted in level 1 hospitals before 08:00 a.m. on the survey day in August 2024. Data were analysed using IBM SPSS version 23.0.

RESULTS: The prevalence of antibiotic use among inpatients was 59.0%, with ceftriaxone being the most prescribed. Antibiotics were prescribed mainly for paediatrics and male inpatients. This study found that 53.0% of prescribed antibiotics were from the Access group while 38.2% were from the Watch group of the World Health Organization Access, Watch, and Reserve (AWaRe) classification. Adherence to national treatment guidelines was 36.0%, with most antibiotics prescribed empirically without evidence of culture and sensitivity tests.

CONCLUSION: This study found a high use of antibiotics and low adherence to treatment guidelines in level 1 hospitals in Lusaka, Zambia. The findings of this study demonstrate the need to establish and strengthen antimicrobial stewardship programs and strengthen laboratory capacity to aid clinicians in diagnosing, treating, and managing patients across level 1 hospitals in Zambia.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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