Antibiotic Consumption in the Department of Infectious and Tropical Diseases, Point G University Hospital, Bamako, 2020

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Résumé

ntroduction: Global consumption of antibiotics increased by 65% between 2000 and 2015. This use has been boosted by an explosion in the use of antibiotics in low-and middle-income countries. The aim of this study is to assess the antibiotic consumption of patients hospitalised in the infectious and tropical diseases department in Mali. Methods: This is a prospective six-month study from 15 July to 31 December 2020 of patients who received antibiotics while hospitalised in the infectious and tropical diseases department of the Point G University Hospital. All hospitalised patients who received either probabilistic or targeted antibiotic therapy were included in this study. Antibiotic consumption was calculated using the ATC DDJ method. The adequacy between the germs subsequently isolated and the probabilistic antibiotic therapy was evaluated.Results: We included 130 patients out of 184 hospitalised in the department, representing a frequency of antibiotic use of 70.6%. The population studied had a sex ratio of 1 and anaverage age of 40.7±13.1 years. The main indication for probabilistic antibiotic therapy was sepsis secondary to pulmonary infection (34.6%), and the main indication for targeted antibiotic therapy was E. coli gastroenteritis and Mycobacterium tuberculosis pulmonary infection, each with a frequency of 25.5%. The most frequent bacteria isolated in the various pathological products were Escherichia coli, Klebsiella pneumoniae and Mycobacterium tuberculosis. The most commonly used antibiotics were cotrimoxazole with 944.8 DDD (i.e.,263.3 DDD/1000DH), followed by β-lactams with 140.5 DDD (i.e.,39.5 DDD/1000DH), then 5-nitroimidazoles with 131.5 DDD (i.e.,36.6 DDD/1000DH). Overall antibiotic consumption was 1417.8 DDD and 365.1 DDD/1000DH.Conclusion: This study is a first and a review of the situation with a view to improving the monitoring of antibiotic consumption and the frequency of bacterial resistance in the coming years.

Mots-clés

Antibiotics, consumption, defined daily dose (DDD), bacteria, infections