Antibiotics use evaluation among hospitalized adult patients at Jimma Medical Center, southwestern Ethiopia: the way to pave for antimicrobial stewardship

Abstract

Background An irrational antibiotic use is a common problem in developing countries like Ethiopia, which makes empiric antibiotics use difficult. It is considered to be the greatest health problem in our time and future unless intervened. Therefore, this study aimed to assess the patterns of antibiotics use among hospitalized adult patients to pave the way for antimicrobial stewardship. Methods A hospital-based prospective observational study was conducted at Jimma Medical Center, southwestern Ethiopia, from 30 October 2020 to 29 January 2021 with 360 adult hospitalized patients participating. A semi-structured questionnaire and consecutive sampling technique was used for data collection. The data were collected through medical record reviews and patient interviews. The collected data were entered into Epi-data and exported to SPSS® version 23.0 for analysis. Days of therapy (DOT) and essential medicine lists “Access, Watch, and Reserve (AWaRe)” antibiotics classification were used to assess antibiotic use pattern among participants. Results The majority of study participants were females (55.3%), attended formal education (59.4%), and live in rural areas (61.4%) with mean age ± (SD) of 37.65 ± (16.75). The overall rate of antibiotics consumption during the study was 111 days of therapy per 100 bed-days and about two-thirds (66%) of the prescribed antibiotics were from the “Watch” group antibiotics. The indicator level of antibiotics use for “Access” group antibiotics was 34% in this study based on the World Health Organization Essential Medicine List. Cephalosporins were the most commonly used class of antibiotics (93.9%). Conclusion Higher antibiotics exposure and their consumption frequently observed among adult hospitalized patients in the study setting. There was a rapid increase in “Watch” group antibiotics use and about two-thirds of the prescribed antibiotics were from this group. The third-generation cephalosporin were the most commonly used class of antibiotics. Generally, higher consumption and inappropriate antibiotics use among hospitalized adult patients showed the need for urgent interventions by implementing Antimicrobial Stewardship Programs in hospitals.

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

“…The role of quality indicators, whether as part of ASPs or separately, is also growing across countries, including African countries, to improve antibiotic prescribing in hospitals, including those based on the AWaRe classification [ 58 , 60 , 64 , 112 , 122 , 123 ]. This is because one way of measuring, monitoring and improving the quality of care is to use indicators, which are standardized measures of healthcare quality that make use of readily available, easy-to-use data independent of subjective judgement.…”

Attitudes and Practices of the Use of Third-Generation Cephalosporins among Medical Doctors Practicing in Cameroon

“…Also, this route presents a bioavailability of 100%, since the pharmaceutical active ingredient usually reaches the site of action without sufering alterations due to presystemic efects [16][17][18][19]. Tough this route is very efcient, it needs the application of the right dose of the drug due to right prescription, for low or high dose of the drug may lead to many consequences such as antibiotic resistance, low efcacy of the drug, long stay in the hospital, and long treatment leading to high cost and possible high mortality rate [20][21][22]. Te result of our study showed that ceftriaxone was used as empirical treatment in 100% of patients, which is higher than 79.5% in a study performed by Sileshi et al [11], 83.7% in a study conducted by Ayele et al [15], and 82% in a study conducted by Pereira et al [12].…”

“…33% (35) (Table 5 and Figure 2). A total of 59.6% (31) indicated that misuse was performed by nurses, and up to 40.4% (21) indicated misuse was performed by medical doctors (Figure 3).…”

Prevalence of nosocomial infection and associated factors among paediatric patients admitted to Jimma medical center, Oromia region, southwest Ethiopia. Cross-Sectional Study

“…It can also serve 11,000 emergency cases and 4500 deliveries per year. It has 800 beds and 1600 staff members (24).…”