Pattern of Antimicrobial Susceptibility and Antimicrobial Treatment of Neonates Admitted with Suspected Sepsis in a Teaching Hospital in Ghana, 2021

Kwaku Anim Omenako (), Anthony Enimil, Afia Frimpomaa Asare Marfo, Collins Timire, Palanivel Chinnakali, Ama Fenny, Kathiresan Jeyashree and Kwame Ohene Buabeng
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Kwaku Anim Omenako: Eastern Regional Hospital, Ghana Health Service, Koforidua P.O. Box KF 201, Ghana
Anthony Enimil: Komfo Anokye Teaching Hospital (KATH), Kumasi P.O. Box KS 1934, Ghana
Afia Frimpomaa Asare Marfo: Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana
Collins Timire: Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, 68 Boulevard Saint Michel, 75006 Paris, France
Palanivel Chinnakali: Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry 605006, India
Kathiresan Jeyashree: Department of Epidemiology and Biostatistics, National Institute of Epidemiology, Chennai 600077, India
Kwame Ohene Buabeng: Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana

IJERPH, 2022, vol. 19, issue 19, 1-14

Abstract: Neonatal sepsis is a life-threatening emergency, and empirical antimicrobial prescription is common. In this cross-sectional study of neonates admitted with suspected sepsis in a teaching hospital in Ghana from January–December 2021, we described antimicrobial prescription patterns, compliance with national standard treatment guidelines (STG), blood culture testing, antimicrobial resistance patterns and treatment outcomes. Of the 549 neonates admitted with suspected sepsis, 283 (52%) were males. Overall, 529 (96%) received empirical antimicrobials. Most neonates ( n = 407, 76.9%) were treated empirically with cefuroxime + gentamicin, while cefotaxime was started as a modified treatment in the majority of neonates (46/68, 67.6%). Only one prescription complied with national STGs. Samples of 257 (47%) neonates underwent blood culture testing, of which 70 (27%) were positive. Isolates were predominantly Gram-positive bacteria, with coagulase-negative Staphylococcus and Staphylococcus aureus accounting for 79% of the isolates. Isolates showed high resistance to most penicillins, while resistance to aminoglycosides and quinolones was relatively low. The majority of neonates ( n = 497, 90.5%) were discharged after successfully completing treatment, while 50 (9%) neonates died during treatment. Strengthening of antimicrobial stewardship programmes, periodic review of STGs and increased uptake of culture and sensitivity testing are needed to improve management of sepsis.

Keywords: antimicrobial resistance; neonatal sepsis; prescription; compliance; empirical antimicrobial treatment; standard treatment guidelines; SORT IT; operational research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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