Point Prevalence Survey Using the Global PPS Tool and Antimicrobial Use at Albert Royer National Children’s Hospital, Dakar, Senegal

Abstract

Aims: The Global Point Prevalence Survey (Global-PPS) provides a standardized tool to measure and monitor antimicrobial prescribing and resistance worldwide. Study Design:  A descriptive, cross-sectional point prevalence survey. Place and Duration of Study: Albert Royer National Children’s Hospital Center in Dakar, Senegal, between two consecutive days (16-17 November 2021). Methodology: This study was conducted among hospitalized patients who were receiving oral or parenteral antimicrobial therapy. Data collection followed Global-PPS inclusion criteria and guidelines. Information was recorded using standardized survey forms, entered into Microsoft Excel, and analyzed using Epi Info version 7. Results: Seven clinical departments were included in the survey, with 82 inpatients out of 108 functional beds, representing a bed occupancy rate of 75.9%. Among these, 54 patients (65.9%) were receiving antimicrobials, including 6 (11.1%) treated for healthcare-associated infections. The mean age of patients was 62.1 months, and the most represented age group was 3-60 months (31.4%). Respiratory infections, particularly pneumonia (25.9%), were the most common diagnoses, followed by sepsis (18.5%), central nervous system infections (13%), and severe malaria (7.4%). Samples for microbiological testing were collected from 40.7% (22/54) of patients, with 9 (40.9%) yielding positive results. Isolated bacteria included Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacter spp., and Klebsiella pneumoniae. Plasmodium falciparum was identified in four patients. Antibiotics were the most frequently used antimicrobials (90.6%), followed by antiparasitic agents (7.4%) and antituberculosis drugs (3.7%). Combination therapy was predominant (46.3%), followed by monotherapy (40.7%). Third-generation cephalosporins were the most prescribed antibiotics (87.0%), mainly cefotaxime (46.3%) and ceftriaxone (40.7%), followed by penicillins (13%), quinolones (9.2%), aminoglycosides (48.1%), imipenem (18.5%), and vancomycin (29.6%). Conclusion: Antibiotics, particularly third-generation cephalosporins, remain the most commonly prescribed antimicrobials in pediatric practice. Strengthening adherence to national antibiotic guidelines and enhancing diagnostic stewardship are essential to reduce antimicrobial resistance pressure and promote rational antimicrobial use.