A survey of antibiotic prescribing patterns and in-vitro antibiotic susceptibility patterns at the University Teaching Hosptal, Lusaka,Zambia ,1998

The development of drug resistance to common pathogens, has generated much concern in the medical community. The absence of an antibiotic policy at the University Teaching Hospital (UTH), has resulted in a high frequency of antibiotic prescription and probable inappropriate use. This may have contributed to the increase in antibiotic resistance at the institution. The survey revealed a high frequency of 73 percent, with the four specialities: Medicine, Paediatrics, Surgery and Obstetrics and Gynaecology, 67 percent, 74 percent, 90 percent and 64 percent, respectively. Multiple antibiotic prescriptions was common (61 percent), adding to the cost of care. The most common antibiotic prescribed was Gentamicin and the common combination was Gentamicin-Penicillin. Common sites of infection were the lower respiratory tract, abdominal and wounds. Antibiotic resistance was high in the readily available cheaper antibiotics, namely Ampicillin (26%, 70%) , Cotrimoxazole (56%, 67%), Tetracycline (59%, 72%), and Chloramphenicol (8%, 50%) in Gram-positive and Gram-negative organisms, respectively, and as low as zero percent in the expensive ones, i.e. Cefotaxime (19%, 2%) and Ciprofloxacin (0%, 1%), respectively.
There is not much utilization of laboratory data and services in deciding on antibiotic use. Surveillance of bacterial resistance will provide health authorities,
physicians, and even pharmaceutical companies, with data on which the use of antibiotic may be rationalised.