Antimicrobial prescription pattern in a tertiary hospital

Olayinka, Adebola; Jimoh, Olanrewaju; Ejembi, Joan; Ige, Oluwafemi Temidayo; Lamido, Zainab; Aliyu, Ibrahim; Aganabor, Victoria; Olayinka, Busayo Olalekan

doi:10.4103/smj.smj_17_18

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…These findings support the observation that irrational antibiotic prescribing is still a major problem, posing a threat of antibiotic resistance in developing countries. 29 Antimicrobial misuse and overuse are important drivers of antimicrobial resistance (AMR), which is a huge global public health problem currently, 30 mainly in sub-Saharan Africa, where AMS initiatives are not frequently adopted. 31 For example, despite the fact that viral diseases such as colds and flu cannot be treated with antibiotics, patients are nonetheless given antibiotic prescriptions for such disorders.…”

Section: Discussionmentioning

confidence: 99%

WHO/INRUD prescribing indicators among tertiary regional referral hospitals in Dar es Salaam, Tanzania: a call to strengthen antibiotic stewardship programmes

Costantine,

Bwire,

Myemba

et al. 2023

JAC-Antimicrobial Resistance

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Background Antibiotic prescribing should be guided by national essential medicines lists (NEMLs) and treatment guidelines; however, there are inadequate data on antibiotic utilization patterns in tertiary hospitals in Tanzania. This study aimed to determine antibiotic prescribing patterns in tertiary hospitals in Dar es Salaam, Tanzania. Methods A retrospective cross-sectional study was conducted in three regional referral hospitals. About 200 prescription records from 2020 to 2022 were analysed at each hospital for prescribing patterns using WHO/ International Network of Rational Use of Drugs (INRUD) indicators (1993) and the AWaRe 2021 classification. Factors associated with receiving an antibiotic prescription were assessed using a logistic regression model. Facilities were ranked on prescribing practices using the index of rational drug prescribing (IRDP). Results A total of 2239 drugs were prescribed, of which 920 (41.1%) were antibiotics. An average of 3.7 ± 1.5 (optimal: 1.6–1.8) total medicines and 1.53 ± 0.78 antibiotics were prescribed per patient. About 88.0% (528) of the prescriptions contained antibiotics (optimal: 20.0%–26.8%), while 78.2% (413) of all antibiotic prescriptions contained injections (optimal: 13.4%–24.1%). Furthermore, 87.5% (462) of the antibiotics were prescribed in generic names (optimal: 100%), while 98.7% (521) conformed to the NEML (optimal: 100%). Metronidazole was the most frequently prescribed antibiotic (39.2%; n = 134), followed by ceftriaxone (37.1%, n = 127) and amoxicillin/clavulanic acid (8.5%, n = 29). Conclusions We found substantial empirical prescribing and overuse of antibiotics exceeding WHO recommendations. Antibiotic overuse varied across the hospitals. Being male, having underlying conditions such as diabetes mellitus, and/or being treated at Temeke hospital were associated with receiving an antibiotic prescription. We recommend strengthening antibiotic stewardship programmes in the studied facilities.

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Section: Discussionmentioning

confidence: 99%

WHO/INRUD prescribing indicators among tertiary regional referral hospitals in Dar es Salaam, Tanzania: a call to strengthen antibiotic stewardship programmes

Costantine,

Bwire,

Myemba

et al. 2023

JAC-Antimicrobial Resistance

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“…Antibiotics are a widely prescribed drug in outpatient clinics and among hospitalised patients 30,37 . Unfortunately, misuse of these drugs leads to antibiotic resistance, which is fast becoming a public health issue 37,38 . We observed that 20.4% of the patients reviewed were prescribed antibiotics within the study period.…”

Section: Discussionmentioning

confidence: 99%

Drug Prescription Pattern in a Primary Care Clinic, Southwest, Nigeria

Ilori

Odeyinka

2022

J. Drug Delivery Ther.

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Background: Rational drug use is of the utmost importance in a region such as West Africa, where the prevalence of drug resistance is increasing due to inappropriate use of medications. Objective: This study aimed to assess the pattern of prescription drug use at the General Outpatient Clinic of the University College Hospital, Ibadan. This study also assessed the knowledge and attitude toward rational drug use among prescribing physicians in the Clinic. Design: The study was a retrospective cross-sectional review of patients' records over three years. The medical records were selected by systematic random sampling and subjected to the WHO core drug use indicators. Prescribers at the study site had their knowledge, attitude, and practice (KAP) of rational drug use assessed with a self-administered questionnaire. Results: A total of 795 medical records were analyzed for drug use indicators. The mean number of drugs per encounter was 2.64 ±1.23. The percentage of encounters in which an antibiotic was prescribed was 20.4%, while 71.6% of all drugs prescribed were in the generic form. From the KAP survey, 64% of physicians routinely prescribed both generic and brand names, and 68% admitted they needed further education on rational drug use. Conclusion: Using the WHO core drug use indicators, this study identified some degree of polypharmacy and poor adherence to the generic prescription of drugs. Continuing Medical Education for health workers is encouraged to stem the irrational prescription of medications in the African sub-region. Keywords: Prescription Drugs Use, Rational Use of Medicines, Physician's knowledge, Nigeria

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“…Point prevalence surveys of antibiotic use in Nigeria have shown a high rate of antibiotic prescribing (> 80%) in children, with more than 90% of antibiotics given intravenously [31][32][33][34]. These PPS were either performed in all age groups or over a short period.…”

Section: Introductionmentioning

confidence: 99%

Point prevalence surveys of antibiotic prescribing in children at a tertiary hospital in a resource constraint, low-income sub-Saharan African country—the impact of an antimicrobial stewardship program

Akintan,

Oshun,

Osuagwu

et al. 2024

BMC Pediatr

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Background Resistance to multiple antibiotics by several pathogens has been widely described in children and has become a global health emergency. This is due to increased use by parents, caregivers, and healthcare providers. This study aims to describe the prevalence rates of antibiotic prescribing, ascertain the impact of antimicrobial stewardship programs, and target improving the quality of antibiotic prescribing in the paediatric population over time in a hospital. Method A point prevalence survey of antibiotic use was performed yearly for 4 years to monitor trends in antibiotic prescribing. Data from all patients admitted before 8 a.m. on the day of the PPS were included. A web-based application designed by the University of Antwerp was used for data entry, validation, and analysis (http://www.global-pps.com). Results A total of 260 children, including 90 (34.6%) neonates and 170 (65.4%) older children, were admitted during the four surveys. Overall, 179 (68.8%) patients received at least one antibiotic. In neonates, the prevalence of antibiotic use increased from 78.9 to 89.5% but decreased from 100 to 58.8% in older children. There was a reduction in the use of antibiotics for prophylaxis from 45.7 to 24.6%. The most frequently prescribed antibiotic groups were third generation cephalosporins and aminoglycosides. The most common indications for antibiotic prescription were sepsis in neonates and central nervous system infection in older children. The documentation of reason in notes increased from 33 to 100%, while the stop-review date also increased from 19.4 to 70%. Conclusion The indicators for appropriate antibiotic prescription improved over time with the introduction of antibiotic stewardship program in the department.

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Antimicrobial prescription pattern in a tertiary hospital

Cited by 8 publications

References 10 publications

WHO/INRUD prescribing indicators among tertiary regional referral hospitals in Dar es Salaam, Tanzania: a call to strengthen antibiotic stewardship programmes

WHO/INRUD prescribing indicators among tertiary regional referral hospitals in Dar es Salaam, Tanzania: a call to strengthen antibiotic stewardship programmes

Drug Prescription Pattern in a Primary Care Clinic, Southwest, Nigeria

Point prevalence surveys of antibiotic prescribing in children at a tertiary hospital in a resource constraint, low-income sub-Saharan African country—the impact of an antimicrobial stewardship program

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