Association between Pre-Hospital Antibiotic Exposure and Level of Bacterial Resistance (PHAE Study): A Matched Case Control Study at the Medical and Paediatric wards of Mbarara Regional Referral Hospital-South Western Uganda
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Date
2022
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Abstract
This study aimed to determine the association between pre-hospital antibiotic exposure and level of
bacterial resistance among adult and paediatric patients.
Methods:
In the study, 79 antibiotic pre-exposed patients (cases) were compared with 79 non-pre-exposed patients
(controls) hospitalized at medical and paediatric wards at Mbarara Regional Referral Hospital (MRRH) for
various bacterial diagnoses. Data collected included participant demographics, previous medications and
bacterial culture and sensitivity results. Data was analysed to determine the odds ratios for the
occurrence of bacterial resistance between the cases and controls. Results: Results from the study showed that there was no statistically significant difference in terms of antibiotic resistance between pre-exposed and non-pre-exposed participants (OR: 0.5, 95%CI: 0.045 - 5.51, P = 0.571), whereby “no resistance” was defined as zero antibiotics resisted and “resistance” defined as 1 or more antibiotics resisted. However, when we adjusted the definition of “no resistance” and “resistance” to mean “one or less antibiotics resisted” and “two or more antibiotics resisted” respectively, there was a statistically significant more resistance in pre-exposed participants (cases) compared to non-pre-exposed participants (OR: 7, 95% CI: 1.59 - 30.8; p = 0.010). When the definition of resistance was further adjusted upwards to “three or more antibiotics resisted”, the resistance in cases was still significantly higher compared to controls (OR: 5.4, 95%CI: 2.42 - 12.2, p = 0.000) and when the definition of resistance was further adjusted to “four or more antibiotics resisted”, the OR increased even further (OR: 7.14, 95%CI: 3.24 - 15.8, p = 0.000). Ceftriaxone (17.6%) and amoxicillin (14.1%) were the commonest antibiotics to which participants were pre-exposed.
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Keywords
Antibiotic, Pre-hospital, Resistance, Exposure
Citation
Buzaare, P., Tusiimire, J., Namugambe, J., & Muzoora, C. (2022). Association between Pre-Hospital Antibiotic Exposure and Level of Bacterial Resistance (PHAE Study): A Matched Case Control Study at the Medical and Paediatric wards of Mbarara Regional Referral Hospital-South Western Uganda. https://doi.org/10.21203/rs.3.rs-1953481/v1