High prevalence of antimicrobial prescribing among public health facilities in Central Uganda: findings from point prevalence survey

Aguma, HB, Musoke, D, Lubega, GB ORCID: https://orcid.org/0000-0003-0657-7903, Nabbanja, CE, Brandish, C, Russell-Hobbs, K, Winter, J ORCID: https://orcid.org/0000-0003-3582-7596, Hamilton-Tanner, NNC, Kisekka, E, Niyongabo, F, Brown, MO ORCID: https://orcid.org/0000-0002-9248-8693, Ipingbemi, AE, Nantongo, J, Kizito, IM, Banyen, ER ORCID: https://orcid.org/0009-0004-8836-0402 and Gibson, L ORCID: https://orcid.org/0000-0002-1220-8680, 2025. High prevalence of antimicrobial prescribing among public health facilities in Central Uganda: findings from point prevalence survey. Infection and Drug Resistance, 18, pp. 6093-6112. ISSN 1178-6973

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Abstract

Background: Antimicrobial resistance (AMR) is the number one cause of death globally, and Sub-Saharan Africa bears the most significant burden. Previous studies conducted in Uganda have revealed high rates of antimicrobial prescribing in hospitals, with evidence of widespread inappropriate use, which necessitates the development of targeted interventions. The inappropriate use of antimicrobials is a driver of AMR. We conducted point-prevalence surveys of antimicrobial prescribing in selected health facilities in central Uganda to identify areas for improvement.

Methods: The study utilised the Global Point Prevalence Survey (GPPS) to collect data on antimicrobial prescribing among eight public health facilities in Central Uganda from February to April 2024. Both inpatient and outpatient data were collected in three hospitals and five lower-level health facilities, respectively. The data collection tools adopted from GPPS were employed. Data were collected on patient demographics, antimicrobial therapy details, and compliance with standard treatment guidelines.

Results: The overall prevalence of antimicrobial use among inpatients at the hospitals was 87.2%, and ceftriaxone was the most frequently prescribed antimicrobial, accounting for 30.6% of the prescriptions. Prescriptions for prophylactic use were the most predominant, with prophylaxis for obstetric and gynaecological surgery accounting for 30.7% of the prescriptions. The prevalence of antimicrobial use among outpatients at lower-level health facilities was 60.7%. Amoxicillin was the most prescribed antimicrobial across the sites, accounting for 39.1% of the prescriptions. Upper respiratory tract infections accounted for most prescriptions (45.1%). Standard treatment guideline compliance was nearly half (50.5%) among hospitals, with variations observed among the different study sites.

Conclusion: A high prevalence of antimicrobial prescribing was observed, highlighting the need to enhance antimicrobial stewardship practices in health facilities. Compliance with standard treatment guidelines was average among hospitals but high among the lower-level health facilities. Some of the potential areas for stewardship interventions include broad-spectrum antibiotic prescriptions, prolonged antibiotic prophylactic courses, and inappropriate prescription of antibiotics for upper respiratory tract infections.

Item Type:	Journal article
Publication Title:	Infection and Drug Resistance
Creators:	Aguma, H.B., Musoke, D., Lubega, G.B., Nabbanja, C.E., Brandish, C., Russell-Hobbs, K., Winter, J., Hamilton-Tanner, N.N.C., Kisekka, E., Niyongabo, F., Brown, M.O., Ipingbemi, A.E., Nantongo, J., Kizito, I.M., Banyen, E.R. and Gibson, L.
Publisher:	Dove Medical Press
Date:	2025
Volume:	18
ISSN:	1178-6973
Identifiers:	Number Type 10.2147/IDR.S538507 DOI 2534000 Other
Rights:	© 2025 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, 4.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
Divisions:	Schools > School of Science and Technology Schools > School of Social Sciences
Record created by:	Laura Borcherds
Date Added:	25 Nov 2025 16:51
Last Modified:	25 Nov 2025 16:51
URI:	https://irep.ntu.ac.uk/id/eprint/54804

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