|dc.contributor.author||Makau, Dennis K||
|dc.description.abstract||Background: In hospitalized patients, antibiotics are the most commonly prescribed
drugs. The rising level of antibiotic resistance, caused by frequent and inappropriate use of
antimicrobial agents, is a major concern of health care systems throughout the world.
Meropenem is a second-generation carbapenem with a broad spectrum of activity against a
majority of gram-positive, gram-negative and anaerobic bacteria, hence it is prone to
misuse. and this raises concerns about the emergence of antimicrobial resistance in Kenya
Objectives: The main objective was to describe meropenem utilization, antimicrobial
resistance patterns and factors that influence meropenem prescribing by clinicians at
Kenyatta National Hospital.
Methods: The study was conducted in two parts at Kenyatta National Hospital. The first
was a descriptive quantitative retrospective study describing meropenem utilization
patterns for the period between January 2016 and December 2017. Patient files were
reviewed. The second part was a cross-sectional study on meropenem prescribing practices
by clinicians by use of a self-administered questionnaire. Convenient sampling was
applied. All the abstracted data were subjected to descriptive data analysis. Inferential data
analysis was carried out and a chi-square test was used. The level of significance was set at
0.05. Data analysis was done using SPSS version 20 software. Approval to carry out this
study was granted by Kenyatta National Hospital/University of Nairobi Ethics and
Research Committee (KNH/UoN-ERC)
Results: A total of 452 medical records of patients on meropenem were reviewed.
Meningitis 45 (27.6%) was the major indication in children aged 12 years and below while
soft tissue infection, 75 (26%) was the major indication in patients aged 13 years and
above. 134 (82.2%) children received the optimal dose. Meropenem was used as empirical
therapy in 348 (77%) of the patients. Gram-negative bacteria were the major isolates,
(97.6%) and resistance was high with Acinetobacter baumannii 9 (90.0%). A total of 39
clinicians were interviewed of whom 20 (51.3%) were females. There was a statistically
significant association between specialization and meropenem prescribing practices (p
value=0.04). Most clinicians, 22 (56.4%) relied on the advice of an infectious disease
specialist before prescribing meropenem.
Conclusion: This study has shown that meropenem was mainly used empirically.
Continuous medical education, functional drug therapeutic committees and regular drug
use research programs remain important aspects in promoting rational antimicrobial use.||en_US
|dc.publisher||University of Nairobi||en_US
|dc.rights||Attribution-NonCommercial-NoDerivs 3.0 United States||*
|dc.subject||Meropenem Utilization, Antimicrobial Resistance Patterns||en_US
|dc.title||Meropenem Utilization, Antimicrobial Resistance Patterns and Factors Influencing Meropenem Prescribing and Adherence to Guidelines by Clinicians at Kenyatta National hospital, Kenya||en_US