The Role of Antimicrobial Stewardship in Combating Antimicrobial Resistance: Learning from a Global Point Prevalence Survey in Mbeya, Tanzania

Background: Antimicrobial resistance (AMR) poses a significant threat to human and animal health, with 27.3 deaths per 100,000 infections in sub-Saharan Africa. Tanzania has developed systems to fight misuse of antibiotics causing AMR but little is known about the Antimicrobial Use (AMU) of commonly prescribed antibiotics in Mbeya, Tanzania. The main objective was to determine AMU for extended-spectrum Penicillin, Ceftriaxone and Azithromycin at Mbeya Regional Referral Hospital (MRRH) and Mbalizi District Designated Hospital (MDDH). Methods: The quasi-experiment was conducted in two multidisciplinary Antimicrobial Stewardship (AMS) teams at MRRH and MDDH. The teams performed a baseline assessment on 2nd June 2022 and a follow-up assessment on 7th and 8th September 2022, using G-PPS online methodologies for extended-spectrum Penicillin, Ceftriaxone and Azithromycin. Interventions on guided prescriptions were done by Continuous Medical Education (CME) and Continuous Quality Improvement (CQI) monitored changes in comparison with other subsets of African hospitals of the same level. Results: At MRRH, the baseline was 97 prescriptions for 47 patients, after the CME interventions, the AMU was 107 prescriptions for 59 patients. Penicillin with extended-spectrum was initially prescribed at 24.7% and after CME at 20.6%. Third−generation cephalosporin was initially prescribed at 29.9% and 21.5% after CME. Azithromycin was prescribed at 8.5% and 2.8% after CME. At MDDH baseline was 56 prescriptions for 38 patients and a follow-up of 52 prescriptions, 33 patients) with extended-spectrum Penicillin at 1.8% raised to 1.9%. Third−generation cephalosporin changed from 26.8% to 19.2%. Azithromycin was not given in May and September.