Abstract

ANTIBIOTIC USAGE PATTERN IN A HOSPITAL IN MAURITIUS, THE RATA SCORE AND ITS ASSOCIATION WITH MULTI-DRUG RESISTANCE

Dooshanveer C. Nuckchady*

ABSTRACT

Objectives: To determine the antibiotic consumption rate, the prevalence of antibiotic misuse and the association between misuse of antibiotics with drug resistance in a regional hospital in Mauritius. Methods: A retrospective study was conducted to assess the folders of 109 in-patients who were prescribed antibiotics. The Defined Daily Dose (DDD) per 1,000 patient-days was estimated using WHO‟s methodology. The Rational Use of Antibiotic (RATA) score was calculated to assess misuse of antibiotics; more marks were given when antibiotics were prescribed correctly. Results: The antibiotic consumption rate was 427 DDD per 1,000 patient-days. For every patient who received 17 daily doses of an antibiotic or 20 days of antibiotic therapy or for every decrease in the RATA score by 1.5 points, the patient had a higher probability of being infected with a new multi-drug resistant organism. 90% of antibiotic prescriptions had some deviations from international protocol with respect to their indication, dose, frequency, duration or their coverage of cultured microorganisms. Conclusions: Given the high rate of misuse of antibiotics, the establishment of an antibiotic stewardship program in hospitals in Mauritius would likely be beneficial. Further studies need to be done to more precisely determine the national antibiotic consumption rate in the private sector and in the outpatient setting. In the meantime, national targets on antibiotic consumption should be set to reduce antibiotic misuse.

Keywords: Antimicrobial resistance, antibiotic consumption, defined daily doses, antibiotic misuse, antibiotic stewardship.