Benin; antenatal antibiotic use; antibiotic prophylaxis; caesarean section; postpartum antibiotic use; Microbiology; Biochemistry; Pharmacology, Toxicology and Pharmaceutics (all); Microbiology (medical); Infectious Diseases; Pharmacology (medical); General Pharmacology, Toxicology and Pharmaceutics
Abstract :
[en] The intense use and misuse of antibiotics is undoubtedly the main factor associated with the high numbers of antibiotic-resistant pathogenic and commensal bacteria worldwide. In low-income countries, this misuse and overuse is widespread, with great consequences at the personal and global levels. In the context of user fee exemptions in caesarean sections, we performed a descriptive study in women to assess the use of antibiotics on three levels-antenatal, during caesarean section, and postpartum-in four Beninese hospitals. Out of the 141 women included, 56.7% were using antibiotics. More than the half (71.3%) were taking more than one antibiotic, either for a long time or in acute treatment. In prophylaxis, the timing, dose, and duration of administration were not correctly achieved. Only 31.2% of women received optimal antibiotic prophylaxis. Various antibiotics including broad-spectrum molecules were used in the patients after caesarean section. The use of antibiotics was improper on the three levels studied. The high rate of self-administered antibiotics, the poor achievement of antibiotic prophylaxis, and the postpartum overuse of antibiotics showed a poor quality of care provided in pregnancy. A national policy is essential to improve the use of antibiotics by the general public as well as by professionals.
Disciplines :
Pharmacy, pharmacology & toxicology
Author, co-author :
Dohou, Angèle Modupè ; Louvain Drug Research Institute, Université Catholique de Louvain, Avenue Emmanuel Mounier 73, 1200 Brussels, Belgium ; Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou 01 BP 188, Benin
Buda, Valentina Oana ; Faculty of Pharmacy, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
Yemoa, Loconon Achille; Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou 01 BP 188, Benin
Anagonou, Severin; Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou 01 BP 188, Benin
Van Bambeke, Françoise ; Louvain Drug Research Institute, Université Catholique de Louvain, Avenue Emmanuel Mounier 73, 1200 Brussels, Belgium
Funding: This work was funded in the context of A.M.D.’s Ph.D. research by the “Bourse de co-operation au développement”, Commission de l’Action Internationale of Université catholique de Louvain, Belgium.
Barbosa, T.M.; Levy, S.B. The impact of antibiotic use on resistance development and persistence. Drug Resist.Updates 2000, 3, 303–311. [CrossRef] [PubMed]
Prestinaci, F.; Pezzotti, P.; Pantosti, A. Antimicrobial resistance: A global multifaceted phenomenon. Pathog. Glob. Health. 2015, 109, 309–318. [CrossRef] [PubMed]
Kpokiri, E.E.; Taylor, D.G.; Smith, F.J. Development of Antimicrobial Stewardship Programmes in Low and Middle-Income Countries: A Mixed-Methods Study in Nigerian Hospitals. Antibiotics 2020, 9, 4. [CrossRef]
WHO. New Report Calls for Urgent Action to Avert Antimicrobial Resistance crisis. Jt. News Release. 2019. Available online: https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis (accessed on 6 April 2022).
Kakkar, A.K.; Shafiq, N.; Singh, G.; Ray, P.; Gautam, V.; Agarwal, R.; Muralidharan, J.; Arora, P. Antimicrobial Stewardship Programs in Resource Constrained Environments: Understanding and Addressing the Need of the Systems. Front. Public Health 2020, 8, 140. [CrossRef] [PubMed]
Norwitz, E.R.; Greenberg, J.A. Antibiotics in Pregnancy: Are They Safe? Rev. Obstet. Gynecol. 2009, 2, 135–136.
Brandon Bookstaver, P.; Bland, C.M.; Griffin, B.; Stover, K.R.; Eiland, L.S.; McLaughlin, M. A review of antibiotic use in pregnancy. Pharmacol. Drug Ther. 2015, 35, 1052–1062. [CrossRef]
Affolabi, D.; Alidjinou, K.E.; Dossou-Gbété, L.; Lankpéko, C.M.; Paraiso, M.N.; Anagonou, S.Y. Évaluation de la prescription des antibiotiques en médecine ambulatoire à Cotonou, Bénin. Bull. Soc. Pathol. Exot. 2009, 102, 110–112.
Hounsa, A.; Kouadio, L.; De Mol, P. Automédication par les antibiotiques provenant des pharmacies privées de la ville d’Abidjan en Côte d”Ivoire. Méd. Mal. Infect. 2010, 40, 333–340. [CrossRef]
Elbur, A.I.; Yousif, M.A.E.R.; Elsayed, A.S.A.; Abdel-Rahman, M.E. An audit of prophylactic surgical antibiotic use in a Sudanese Teaching Hospital. Int. J. Clin. Pharm. 2013, 35, 149–153. [CrossRef]
WHO. Prophylactic Antibiotics for Women Undergoing Caesarean Section; WHO: Geneva, Switzerland, 2021.
Kayihura, V.; Osman, N.B.; Bugalho, A.; Bergström, S. Choice of antibiotics for infection prophylaxis in emergency cesarean sections in low-income countries: A cost-benefit study in Mozambique. Acta Obstet. Gynecol. Scand. 2003, 82, 636–641. [CrossRef]
Salkind, R.A.; Rao, C.K. Antibiotic prophylaxis to prevent surgical site infections. Am. Fam. Physician 2011, 83, 585–590. [PubMed]
WHO. Une Chirurgie Plus Sure pour épargner des Vies. 2008. Available online: http://apps.who.int/iris/bitstream/10665/7008 2/1/WHO_IER_PSP_2008.07_fre.pdf (accessed on 15 May 2015).
Morisaki, N.; Ganchimeg, T.; Ota, E.; Vogel, J.P.; Souza, J.P.; Mori, R.; Gülmezoglu, A.M. Maternal and institutional characteristics associated with the administration of prophylactic antibiotics for caesarean section: A secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG An Int. J. Obstet. Gynaecol. 2014, 121, 66–75. [CrossRef] [PubMed]
Elbur, A.I.; Yousif, M.A.; El Sayed, A.S.A.; Abdel-Rahman, M.E. Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital. Health 2014, 6, 158–164. [CrossRef]
Bagheri Nejad, S.; Allegranzi, B.; Syed, S.B.; Ellis, B.; Pittet, D. Health-care-associated infection in Africa: A systematic review. Bull. World Health Organ. 2011, 89, 757–765. [CrossRef] [PubMed]
Affolabi, D.; Ade, G.; Bankolé, H.; Hounkpe, C.; Satchi, A.; SocloDansi, E.; Anagonou, S. Evolution de la résistance bactérienne aux antibiotiques dans les infections courantes à Cotonou. J. Société Biol. Clin. 2012, 16, 79–83.
Ahoyo, T.A.; Bankolé, H.S.; Adéoti, F.M.; Gbohoun, A.A.; Assavèdo, S.; Amoussou-Guénou, M.; Kindé-Gazard, D.A.; Pittet, D. Prevalence of nosocomial infections and anti-infective therapy in Benin: Results of the first nationwide survey in 2012. Antimicrob. Resist. Infect. Control 2014, 3, 17. [CrossRef]
Ahoyo, A.T.; Baba-Moussa, L.; Makoutode, M.; Gbohoun, A.; Bossou, R.; Dramane, K.; Sanni, A.; Prévost, G. Incidence de Staphylococcus aureus résistant à la méticilline dans le service de néonatologie du centre hospitalier départemental du Zou et des Collines au Bénin. Arch. Pediatr. 2006, 13, 1391–1396. [CrossRef]
Ndol, F.M.I.; Bompeka, F.L.; Dramaix-Wilmet, M.; Meert, P.; Malengreau, M.; Mangani, N.N.; Tsobo, F.M.; Koné, D. Self-medication among patients admitted to the emergency department of Kinshasa University Hospital [L’automédication chez des patients reçus aux urgences médicales des Cliniques Universitaires de Kinshasa]. Santé Publique 2013, 25, 233–240. [CrossRef]
Merrett, G.L.B.; Bloom, G.; Wilkinson, A.; MacGregor, H. Towards the just and sustainable use of antibiotics. J. Pharm. Policy Pract. 2016, 9, 1–10. [CrossRef]
WHO. The Role of Education in the Rational Use of Medicines; WHO: Geneva, Switzerland, 2006.
Mondiale, B. “DATABANK”. 2022. Available online: https://donnees.banquemondiale.org/indicator/SE.ADT.LITR.FE.ZS? locations=BJ (accessed on 1 April 2022).
Dong, H.; Bogg, L.; Rehnherg, C. Association between health insurance and antibiotics prescribing in four countries in rural china. Health Policy 1999, 48, 29–45. [CrossRef]
El Zowalaty, E.M.; Belkina, T.; Bahashwan, S.A.; El Zowalaty, A.E.; Tebbens, J.D.; Abdel-Salam, H.A.; Khalil, A.I.; Daghriry, S.I.; Gahtani, M.A.; Madkhaly, F.M.; et al. Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population. Int. J. Clin. Pharm. 2016, 38, 1261–1268. [CrossRef] [PubMed]
Peabody, W.J.; Taguiwalo, M.M.; Robalino, A.D.; Julio, F. Improving the Quality of Care in Developing Countries. In Disease Control Priorities in Developing Countries, 2nd ed.; The World Bank: Washington, DC, USA, 2006; pp. 1293–1308.
Gomez, I.; Ranji, U.; Salganicoff, A. Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey. Kais. Fam. Found. 2018. Available online: https://files.kff.org/attachment/Issue-Brief-Women-Work-and-Family-Health-Key-Findings-from-the-2017-Kaiser-Womens-Health-Survey (accessed on 19 February 2022).
Abdel Jalil, M.H.; Abu Hammour, K.; Alsous, M.; Hadadden, R.; Awad, W.; Bakri, F.; Fram, K. Noncompliance with surgical antimicrobial prophylaxis guidelines: A Jordanian experience in cesarean deliveries. Am. J. Infect. Control 2018, 46, 14–19. [CrossRef] [PubMed]
Apostolopoulou, E.; Zaxos, N.; Georgoudi, A.; Tsakona, M.; Nikoloudi, P. Adherence with guidelines of perioperative antibiotic prophylaxis and cost among women undergoing cesarean section. Rev. Clin.Pharmacol. Pharmacokinet. Int. Ed. 2010, 24, 19–24.
Carlès, M.; Gindre, S.; Aknouch, N.; Goubaux, B.; Mousnier, A.; Raucoules-Aimé, M. Improvement of surgical antibiotic prophylaxis: A prospective evaluation of personalized antibiotic kits. J. Hosp. Infect. 2006, 62, 372–375. [CrossRef] [PubMed]
Kamilya, G.; Seal, S.L.; Mukherji, J.; Roy, H.; Bhattacharyya, S.K.; Hazra, A. A Randomized controlled trial comparing two different antibiotic regimens for prophylaxis at cesarean section. J. Obstet. Gynecol. India 2012, 62, 35–38. [CrossRef]
WHO. Recommended and Non-Recommended Practices to Prevent and Treat. Maternal Peripartum Infections; WHO: Geneva, Switzerland, 2015; Volume 375.
L’ Audit Clinique: Bases Méthodologiques de l’ Évaluation des Pratiques; ANAES/Service Évaluation en Établissements de Santé: Saint Denis La Plaine, France, 1999.
WHO. Enquêtes Mondiales. 2014. Available online: http://www.who.int/gpsc/5may/global-surveys/fr/(accessed on 14 May 2015).
Vrijens, F.; Gordts, B.; De Laet, C.; Devriese, S.; Van De Sande, S.; Huybrechts, M. Nosocomial Infections in Belgium, Part I: National prevalence study. In Health Services Research (HSR); KCE Reports 92C (D/2008/10.273/72); Belgian Health Care Knowledge Centre (KCE): Brussels, Belgium, 2008.
