Prevalence survey of antibiotic usage in a secondary care hospital in east Trinidad and Tobago

Background: Empirical utilisation of antimicrobials has become standard practice in healthcare, but ultimately it may be associated with drug resistance. This study serves to determine the prevalence of antibiotic use at a secondary care hospital in east Trinidad and Tobago. Methods: A cross-sectional study was conducted at the Sangre Grande Hospital. The World Health Organization’s Methodology for Point Prevalence Survey on Antibiotic Use in Hospitals and the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance were adapted for a simple prevalence study involving inpatient and outpatient accident and emergency settings. Researchers reviewed medical records of all patients present at the hospital for the preceding 24 hours for inpatients and 4 hours for patient records reviewed in the accident and emergency department. Information collected included antibiotic class, dosages, frequency, course duration, indication and microbiology data. Data was stored in an Excel spreadsheet. It was analysed using IBM SPSS Statistics for Windows, Version 29.0.2.0 Armonk, NY: IBM Corp, as descriptive statistics. Clinical and Laboratory Standards Institute M100, Version 33, was used to interpret susceptibility data. Results: There were 543 total patients sampled with 218 (40.1%) prescribed antibiotics. The most frequently prescribed classes included cephalosporins (31.4%), penicillins (31.1%) and nitroimidazoles (17.1%). Among the cephalosporins, 56 (54%) were third generation. The most common route of administration was parenteral. Antibiotics were most frequently administered as medical prophylaxis (63.9%). The surgical department was the service with the highest use of antibiotics (31.19%) followed by the emergency medicine department (27.52%). The most frequent systemic indications for antibiotic use were skin and soft tissue infections (32%), obstetric and gynaecological conditions (18%) and sepsis (13%). Out of 218 patients receiving antibiotics, only 9 (4%) cultures were identified as taken. Four species of bacteria were identified and treated based on susceptibility reports. Conclusion: There was greater utilisation of broad-spectrum antibiotics. Microbiology culture reports were not utilised by most services. This report provides an opportunity for improvement of antibiotic stewardship.