Non-prescribed antimicrobial use and associated factors among customers in drug retail outlet in Central Zone of Tigray, northern Ethiopia: a cross-sectional study

Gebrekirstos, Negash Hadera; Workneh, Birhanu Demeke; Gebregiorgis, Yosef Sibhatu; Misgina, Kebede Haile; Weldehaweria, Negassie Berhe; Weldu, Meresa Gebremedhin; Belay, Hailay Siyum

doi:10.1186/s13756-017-0227-7

Cited by 27 publications

(30 citation statements)

References 37 publications

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“…2,5 In Ethiopia, as in many other developing countries where health-care systems are not yet adequately formed to address health problems, antibiotics are used more frequently than any other drugs for both bacterial and non-bacterial infections and are often bought without prescription, 16 which is further compounded by empirical prescription without sensitivity testing. 17,18 Therefore, precise evidence on the pattern of antimicrobial use is vital to respond to the problem of antimicrobial overuse and potential resistance. Hence, the intention of this research is to define the magnitude of inappropriate use of antibiotics among inpatients attending Madda Walabu University Goba Referral Hospital (MWUGRH).…”

Section: Introductionmentioning

confidence: 99%

<p>Inappropriate Antibiotic Use Among Inpatients Attending Madda Walabu University Goba Referral Hospital, Southeast Ethiopia: Implication for Future Use</p>

Mama¹,

Mamo²,

Usman³

et al. 2020

IDR

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Background: Ethiopia is one of the countries where the healthcare system is not yet developed to the required level; hence, it is not uncommon that drugs, particularly antimicrobials, are inappropriately used for infections by any causative agents, with or without prescription, in combination or not, and, of more concern, without sensitivity tests. So, it was considered important to assess the magnitude of inappropriate antimicrobial use among inpatients attending Madda Walabu University Goba Referral Hospital, southeast Ethiopia. Methods: A health institution-based cross-sectional study was conducted from September 2018 to April 2019. Patient folders from collaborating wards were reviewed for antibiotic use. Inappropriateness of a drug or its dosage, or both, was considered in reference to the Ethiopian national treatment guideline. The information obtained was analyzed using SPSS version 20. Patterns of prescription of antimicrobials for the hospitalized patients were analyzed using simple descriptive statistics. Results: A total of 801 antibiotics were written as prescriptions to 471 clients, 228 (47.6%) of whom had received two or more antibiotics at the time of the study. Of the total prescribed antibiotics, 142 (30.1%) had an inappropriate prescription. Genitourinary tract infections accounted for 42 (30.4%) of the inappropriate prescriptions due to the wrong dose and drugs. Cephalosporins were the most extensively prescribed class of antibiotics, 24.4% of which were inappropriately prescribed. Intravenous formulations made up the largest proportion of prescriptions, at 335 (41.8%). The most commonly prescribed antimicrobials were cephalosporins, 178 (38%); nitroimidazoles, 115 (24.5%); and macrolides, 53 (11.3%), while ceftriaxone was prescribed in 249 (53%) and metronidazole in 123 (26.2%) cases. Conclusion: Low dose, inadequate duration and empiric use of antibiotics were major causes of inappropriate use in the study area. Therefore, local antimicrobial sensitivity tests, antibiotic stewardship and following the national treatment guideline are recommended to overcome inappropriate antimicrobial use.

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Section: Introductionmentioning

confidence: 99%

<p>Inappropriate Antibiotic Use Among Inpatients Attending Madda Walabu University Goba Referral Hospital, Southeast Ethiopia: Implication for Future Use</p>

Mama¹,

Mamo²,

Usman³

et al. 2020

IDR

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“…In countries with immature healthcare systems antibiotics are among the most commonly used drugs [ 3 – 5 ] and resistance rates can be up to 100% for ordinary pathogenic microbes [ 6 – 8 ]. In urban as well rural areas antibiotics are often bought without a prescription and used both for viral and bacterial infections [ 9 ]. It can be difficult to know if the drugs have any effect, especially since most drugs are prescribed empirically without sensitivity testing [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Multiple challenges of antibiotic use in a large hospital in Ethiopia – a ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis

Gutema

Håkonsen

Engidawork

et al. 2018

BMC Health Serv Res

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BackgroundThis project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patients on antibiotics, quantify the antibiotic consumption and identify the main indications of use.MethodThe material was all the medical charts (n = 2231) retrieved from three clinical wards (internal medicine, gynecology/obstetrics and surgery) in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa between September 2013 and September 2014. Data collection was performed manually by four pharmacists.ResultsEach medical chart represented one patient. About 60% of the patients were admitted to internal medicine, 20% to each of the other two wards. The number of bed days (BD) was on average 16.5. Antibiotics for systemic use were prescribed to 73.7% of the patients (on average: 2.1 antibiotics/patient) of whom 86.6% got a third or fourth generation cephalosporin (mainly ceftriaxone). The average consumption of antibiotics was 81.6 DDD/100BD, varying from 91.8 in internal medicine and 71.6 in surgery to 47.6 in gynecology/obstetrics. The five most frequently occurring infections were pneumonia (26.6%), surgical site infections (21.5%), neutropenic fever (6.9%), sepsis (6.4%) and urinary tract infections (4.7%). About one fourth of the prescriptions were for prophylactic purposes. Hospital acquired infections occurred in 23.5% of the patients (353 cases of surgical site infection). The prescribing was based on empirical treatment and sensitivity testing was reported in only 3.8% of the cases.ConclusionsIn the present study from three wards in the largest tertiary teaching hospital in Ethiopia, three out of four patients were prescribed antibiotics, primarily empirically. The mean antibiotic consumption was 81.6 DDD/100BD. Surgical site infections constituted a large burden of the infections treated in the hospital, despite extensive prescribing of prophylaxis. The findings show the need to implement antibiotic stewardship programs in Ethiopian hospitals with focus on rational prescribing, increased sensitivity testing and better procedures to prevent hospital acquired infections.

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“…Understanding which conditions can be treated with antibiotics is very important, as the use of antibiotics for conditions which are not in fact treatable with these medicines is another contributor to misuse, and therefore to the development of resistance. Various studies show that public awareness on antibiotic use can influence patient demand for antibiotic 19,20 . Therefore, stronger prescription policies might be solution for antibiotic resistance control and prevention of antibiotic resistance.…”

Section: Discussionmentioning

confidence: 99%

Public knowledge and awareness towards antibiotics use in Yogyakarta: A cross sectional survey

Kristina¹,

Wati²,

Prasetyo³

2020

Pharm Sci Asia

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Irrational use of antibiotics is a public health problem. Our study aimed to evaluate knowledge and awareness of antibiotics, and to examine its' associated factors. We conducted a cross sectional survey. The questionnaire was adapted from WHO Multi-country survey. Adults aged 18 years old and were receiving prescription from eight outpatient clinics and pharmacies in Yogyakarta province completed the survey. The questionnaire was consisted of three sections, i.e. sociodemographic factors, knowledge of antibiotics, and experiences in using antibiotics. Scores on questions and data were presented descriptively and analyzed using logistic regression to evaluate the influence of variables on knowledge of antibiotics. Out of 268 respondents, a cumulative 76% of them used antibiotics in last six months. Majority of respondents (58%) had low level knowledge on antibiotic use and awareness, and incorrectly identified that cold and cough are treatable with antibiotics (75%). Interestingly, 71% of participants agreed that internet is a major source of information on antibiotics (71%), while only 58% and 45% of respondents see pharmacists and medical professionals respectively. The antibiotics were received from prescription (79%) and 70% of respondents completed the full course of antibiotics prescribed, but only 32% of them became more cautious about antibiotic use. We found the highest association between gender, age, education level, with the knowledge of antibiotics. The overall level of knowledge and awareness on antibiotics use among residents in Yogyakarta is low. This mandates public health awareness intervention programs to be implemented on the use of antibiotics.

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Non-prescribed antimicrobial use and associated factors among customers in drug retail outlet in Central Zone of Tigray, northern Ethiopia: a cross-sectional study

Cited by 27 publications

References 37 publications

<p>Inappropriate Antibiotic Use Among Inpatients Attending Madda Walabu University Goba Referral Hospital, Southeast Ethiopia: Implication for Future Use</p>

<p>Inappropriate Antibiotic Use Among Inpatients Attending Madda Walabu University Goba Referral Hospital, Southeast Ethiopia: Implication for Future Use</p>

Multiple challenges of antibiotic use in a large hospital in Ethiopia – a ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis

Public knowledge and awareness towards antibiotics use in Yogyakarta: A cross sectional survey

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