Perception and practices of prescribers on the prescription of surgical antibiotic prophylaxis and resistance at Kamuzu central, Bwaila and Area 25 hospitals in Lilongwe
Abstract
Research study: The study will be a cross-section, quantitative, descriptive design.
Problem statement: Antimicrobial Resistance is a global public health threat to humans. The World Health
Organization also indicates that antimicrobial resistance has reached alarming levels in many
parts of the world including low- and middle-income countries such as Malawi. This is
attributed to inappropriate use of antimicrobials at different levels in the health system. It is
also certain that health workers such as prescribers have highly contributed through irrational
prescription practices and surgical antimicrobial prophylaxes. Antimicrobial prophylaxis
refers to a short course of antimicrobial therapy administered prior to surgery to reduce
microbial counts to a level that will not overwhelm host immune response. Hospital acquired
infections is a major contributor to increased mortality and health care costs due to
development of resistant microorganism. There are reports of increased number of acquired
surgical infections which some lead to amputation of leg, hysterectomies of young women in
the surgical wards of these public hospitals. It is not clear whether it is due to irrational pre
and post-operative prescription of the antibiotics which may lead to resistance of organisms
to antibiotics. It is also not known whether health professionals follow the guidelines of
prophylactic antibiotics hence the study will look into the practices and perception of
prescribers on the use of surgical antibiotic prophylaxis and resultant resistance in different
wards at Kamuzu Central Hospital (KCH), Bwaila and Area 25 hospitals in Lilongwe,
Malawi.
Aim of study: The aim of this study is to assess the perception and practices among prescribers on the use of
surgical antibiotics prophylaxis in public hospitals of Bwaila, Area25, and Kamuzu Central
Hospital (KCH) in Lilongwe, Malawi.
Objectives a) Assess knowledge of prescribers on the use of surgical antibiotic prophylaxis
and resistance, b) To evaluate perception on the use of antibiotic prophylaxis and resistance
among prescribers, c) To assess adherence to guidelines of surgical antibiotic prophylaxis
among prescribers. Methodology
A cross-sectional, quantitative, descriptive study design will be used. This study will be
conducted in three public hospitals. It will target all prescribers who work in the mentioned
hospitals. Study period will start in October 2019 to October 2020. This study is expected to
have 169 individuals to participate. Ethical approval from College of Medicine Research Ethical
Committee (COMREC) and permission from the Director – Kamuzu Central and District Health
Office (DHO) will be sought. Study participants will give consent before participation.
Questionnaire will be used to collect data. Data will be analyzed using SPSS. Results will be
presented in form of tables, histograms and pie chart
Expected findings and dissemination
It is anticipated that factors contributing to high rate of surgical infections and knowledge level
on the use of surgical antibiotic prophylaxis and resistance will be known. Furthermore, poor
adherence to prophylaxis antibiotic guidelines and irrational prescription of antibiotics by
prescribers will be established. The results will be presented in form of dissertation to College of
Medicine, University of Malawi and copies will be submitted to College of Medicine Research
and Ethical Committee, College of Medicine Library and College of Medicine
Pathology Department.