Antibiotic Consumption in the Department of Infectious and Tropical Diseases, Point G University Hospital, Bamako, 2020

Abstract

Introduction: Global consumption of antibiotics increased by 65% between 2000 and 2015. This use has been
boosted by an explosion in the use of antibiotics in low- and middle-income countries. The aim of this study is to
assess the antibiotic consumption of patients hospitalised in the infectious and tropical diseases department in
Mali. Methods: This is a prospective six-month study from 15 July to 31 December 2020 of patients who received
antibiotics while hospitalised in the infectious and tropical diseases department of the Point G University Hospital.
All hospitalised patients who received either probabilistic or targeted antibiotic therapy were included in this study.
Antibiotic consumption was calculated using the ATC DDJ method. The adequacy between the germs
subsequently isolated and the probabilistic antibiotic therapy was evaluated. Results: We included 130 patients
out of 184 hospitalised in the department, representing a frequency of antibiotic use of 70.6%. The population
studied had a sex ratio of 1 and an average age of 40.7±13.1 years. The main indication for probabilistic antibiotic
therapy was sepsis secondary to pulmonary infection (34.6%), and the main indication for targeted antibiotic
therapy was E. coli gastroenteritis and Mycobacterium tuberculosis pulmonary infection, each with a frequency of
25.5%. The most frequent bacteria isolated in the various pathological products were Escherichia coli, Klebsiella
pneumoniae and Mycobacterium tuberculosis. The most commonly used antibiotics were cotrimoxazole with
944.8 DDD (i.e., 263.3 DDD/1000DH), followed by β-lactams with 140.5 DDD (i.e., 39.5 DDD/1000DH), then
5-nitroimidazoles with 131.5 DDD (i.e., 36.6 DDD/1000DH). Overall antibiotic consumption was 1417.8 DDD
and 365.1 DDD/1000DH. Conclusion: This study is a first and a review of the situation with a view to improving
the monitoring of antibiotic consumption and the frequency of bacterial resistance in the coming years.