Antimicrobial sensitivity testing in 3 Ugandan Hospitals

The dispensed antibiotics and AST antibiotic-disks were compared using spearman’s rank correlation test. Of the 607 in-patient files reviewed, AST was requested in 24 (4.0%), and done in 13 (2.1%). All three hospitals used the Kirby-Bauer disk diffusion method for AST, with a median turnaround time of 5 days (IQR 4-8).

While the frequently used AST antibiotic-disks were cotrimoxazole (13.0%), ampicillin (11.7%), and ceftriaxone (10.5%), the most dispensed antibiotics were metronidazole (30.3%), amoxicillin (19.6%) and ceftriaxone (14.8%). There was a weak correlation (r=0.313, p=0.120) between dispensed antibiotics and AST antibiotic-disks. We report an underutilization of AST, and the few tests that were performed were discordant with the most dispensed antibiotics.

The commonly used disk diffusion method in hospitals of resource-limited settings is inexpensive but has a long turnaround time. We recommend alternative faster and cost-effective AST methods.