Quality of antibiotics prescription in hospitals in Burkina Faso: a multispecialty clinical audit

BACKGROUND: Irrational use of antibiotics is one of the main factors in the emergence of antibiotic resistance. In Burkina Faso, where rates of antimicrobial resistance (AMR) are increasing, hospital prescribing practices remain understudied. This study evaluated the appropriateness of antibiotic prescriptions in three regional hospitals in Burkina Faso to identify gaps and inform stewardship interventions. METHOD: This retrospective clinical audit examined patient records from May to July 2023. It was conducted in August 2023 to assess 450 randomly selected patient records from the paediatric, surgical, gynaecology-obstetrics, emergency medicine and general medicine departments. Using Burkina Faso's Practical Guide to Antibiotic Prescription as a reference, the records were assessed for the relevance of the prescriptions, the choice of antibiotics, the dosage, the duration and adherence to antimicrobial susceptibility testing (AST). The data were analysed using Excel 2019. RESULTS: The audit revealed critical deficiencies in the antibiotics prescription in the hospitals. Only 31.1% (140/450) of antibiotics were chosen correctly, 26.2% (118/450) of dosages were correct, 31.1% of choices agreed with the reference, and 21.6% (97/450) of durations were correct. The percentages for routes of administration such as oral, injection, local route and reassessment at 72 h and one week were 66.4% (299/450), 62.7% (282/450) and 43.1% (194/450) respectively. The audit revealed the underutilisation of AST, only 1.8% (8/450) of prescriptions. CONCLUSION: This study highlights gaps in antibiotic prescribing practices, the selection of antimicrobials, and the low prescription of AST. Strengthening antimicrobial stewardship programmes and strict adherence to national guidelines are urgently needed to optimise antibiotic use and combat resistance.