JAC Antimicrob Resist https://doi.org/10.1093/jacamr/dlae220 JAC- Antimicrobial Resistance Antibiotic use at the Centre Hospitalier Universitaire de Zone d’Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin: a point prevalence survey Morelle Sèssiwèdé Gnimavo 1,2 , Bawa Boya 3 , Steward Mudenda 4,5 * and Aurel Constant Allabi 1,2 1 Laboratory of Pharmacology and Toxicology, University of Abomey-Calavi, 05 BP 1604 Cotonou, Benin; 2 Teaching Hospital of Abomey- Calavi/Sô-Ava, 05 BP 1604 Contonou, Benin; 3 Laboratory of Biology and Molecular Typing in Microbiology (LBTMM), University of Abomey- Calavi, 05 BP 1604 Cotonou, Benin; 4 Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia; 5 Surveillance and Research Technical Working Group, Antimicrobial Resistance Coordinating Committee, Zambia National Public Health Institute, Lusaka, Zambia *Corresponding author. E-mail: steward.mudenda@unza.zm Received 22 July 2024; accepted 24 December 2024 Background: Antimicrobial stewardship promotes the appropriate use of antibiotics to prevent the emergence and spread of antimicrobial resistance. This study evaluated the use of antibiotics using a point prevalence sur- vey at the Centre Hospitalier Universitaire de Zone d’Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin. Methods: This cross-sectional study utilized the WHO point prevalence survey methodology for monitoring anti- biotic use among inpatients in hospitals. The survey was conducted from 11 January 2022 to 19 January 2022 among hospitalized patients before 8:00 a.m. on the day of the survey. Results: Of the 111 inpatient medical files reviewed, the prevalence of antibiotic use was 82.9%. The number of antibiotics received per patient ranged from 1 to 5, with a mean of 2.45 ± 1.11 and a median of 2. The most com- monly prescribed class of antibiotics was beta-lactams (46.7%), aminoglycosides (20.6%) and nitroimidazoles (19.7%). According to the WHO AWaRe classification, 30.4% of inpatients received the Access group of antibio- tics and 44% received a combination of Access and Watch group antibiotics; treatment was empiric in 94.5% of encounters. Only 22.7% of patients were treated based on microbiological examination/culture and sensitivity testing. Conclusions: This study found a high prevalence of antibiotic use among inpatients at the CHUZ/AS Tertiary Care Hospital in Benin. The most prescribed antibiotics were ampicillin, metronidazole and ceftriaxone. Consequently, the study found a low use of culture and sensitivity testing to guide treatment, particularly in the paediatric and surgical population, and the preference for broad-spectrum antibiotics suggests that antibiotic use at the CHUZ/ AS Tertiary Care is not optimal. Therefore, antimicrobial stewardship programmes, policies and guidelines must be instigated and strengthened to address these gaps and promote rational use of antibiotics. © The Author(s) 2025. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/ by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction Antimicrobial resistance (AMR) threatens global public health and sustainable development, with adverse health and economic consequences, unless evidence-based efforts are implemented to control its emergence and spread. 1–3 The health and social consequences of AMR include increased morbidity and mortality, rising healthcare costs and an anticipated negative impact on economic growth. 4 More than 700 000 people die each year from AMR, a figure that is expected to rise to 10 million annually by 2050 if decisive action is not taken. 3,5 A recent estimation of 39 million deaths due to AMR has been reported. 6 Less is known about the impact of this problem in African countries although the burden is considered high. 7 The overuse and misuse of antimicrobials are considered im- portant drivers of AMR. 8–11 In the USA, around 30% of antimicro- bial treatments are considered inappropriate. 12 In African countries, these estimates exceed 45% and vary within primary and tertiary care settings. 13,14 Thus, healthcare facilities where antimicrobials are frequently used are high-risk environments for the selection and spread of resistant bacteria. 15 There can be significant variation in antibiotic use between facilities, 16 with greater variations observed between facilities experiencing different rates of nosocomial infections and serving populations with varying burdens of disease. In low- and middle-income countries (LMICs), the burden of AMR is likely to be high and ac- cess to antibiotics is largely unregulated. 3,17–20 Data of this 1 of 11 Downloaded from https://academic.oup.com/jacamr/article/7/1/dlae220/7951245 by guest on 10 January 2025