Prescription of antibiotics and in vitro bacterial resistance during infectious pathologies in patients received at CHUL
The proper use of antibiotics in hospitals is essential to facilitate rational use. This is relevant for reducing the progression of antimicrobial resistance. The objective of the study was to evaluate the prescription of antibiotics commonly prescribed in the care services of the Libreville University Hospital (CHUL) and to present the bacterial resistance of bacteria to these antibiotics. A survey on antibiotic prescriptions at the CHUL among patients seen in consultation in the healthcare services was carried out using a questionnaire developed for this purpose. Following blood culture, the identification of bacterial strains and the study of sensitivity to antibiotics were carried out respectively by API 20E gallery Biomerieux and by the disk diffusion method (Kirby Bauer) with detection of bacterial resistance phenotypes. In total, 114 antibiotic prescriptions were analyzed. Probabilistic antibiotic therapy represented 71.93% of prescriptions. 107 gram-negative bacillus bacterial strains were the subject of an antibiotic sensitivity study. Klebsiella species spp and Burkholderia spp were mostly isolated. The most prescribed molecule was amoxicillin-clavulanic acid (12.71%). More than half of the prescriptions were inappropriate. The majority of bacterial strains presented resistance to commonly prescribed antibiotics (80%). The status of the prescriber and the prescriber's department were factors influencing the appropriateness of prescriptions. Inappropriate use of antibiotics was common in this study. The biological re-evaluation of antibiotic therapy is essential to combat the misuse of antibiotics and bacterial resistance, particularly in the context of probabilistic antibiotic therapies. Therefore, the implementation of a clinical-biological antibiotic therapy tool seems essential to guarantee better management of infections of bacterial origin.