Prevalence of antimicrobial resistance and its clinical implications in Ethiopia: a systematic review

Berhe, Derbew Fikadu; Beyene, Getachew Tesfaye; Seyoum, Berhanu; Gebre, Meseret; Haile, Kassa; Tsegaye, Mulugeta; Boltena, Minyahil Tadesse; Tesema, Emawayish; Kibret, Taddele Cherinet; Biru, Mulatu; Siraj, Dawd; Shirley, Daniel; Howe, Rawleigh; Abdissa, Alemseged

doi:10.1186/s13756-021-00965-0

Cited by 33 publications

(35 citation statements)

References 26 publications

(19 reference statements)

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“… 6 The poor hygiene along with the growth in immunocompromised patients are further exaggerating the AMR in Sub-Saharan Africa (SSA). 6 It was claimed that the majority of global antibiotic consumption between 2000 and 2015 was in LMICs, especially in SSA, mainly due to their high incidence of infectious diseases. Additionally, it was reported that most of the deaths are expected to be in SSA owing to their low financial capability of the health care system.…”

Section: Introductionmentioning

confidence: 99%

“…5 The current situation in African countries is catastrophic and very difficult to precisely describe since very few countries give a regular national surveillance report on AMR. 6 The poor hygiene along with the growth in immunocompromised patients are further exaggerating the AMR in Sub-Saharan Africa (SSA). 6 It was claimed that the majority of global antibiotic consumption between 2000 and 2015 was in LMICs, especially in SSA, mainly due to their high incidence of infectious diseases.…”

Section: Introductionmentioning

confidence: 99%

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Knowledge, Attitude and Practice of Community Pharmacists in Relation to Dispensing Antibiotics Without Prescription in Sudan: A Cross-sectional Study

Hussain¹,

Mohamed²,

Abkar³

et al. 2022

IPRP

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Background Dispensing antibiotics without prescription (DAwP) is a widespread practice, especially in developing countries, contributing to antibiotic resistance. Community pharmacists play a significant role in promoting rational use of antibiotics by refraining from DAwP, and providing drug information to patients. This study aimed to evaluate community pharmacists’ knowledge, attitude and practice, and to assess the factors behind DAwP. Methods A cross-sectional study was conducted in 2020 among random sample of community pharmacists in Sudan. Online semi-structured questionnaire was used for data collection. The association between dependent and independent variables was assessed using Chi-square test; a P -value less than 0.05 was considered significant. Results Of the 1217 pharmacists who participated, the majority were female (n = 645, 53%). Most pharmacists have a B. Pharm degree (n = 1026, 84%) and less than 5 years’ experience (n = 718, 59%). Notably, the majority of community pharmacists have good knowledge (n = 735, 61.7%), which is significantly associated with years of experience (P < 0.00). More than half (n = 623, 52.2%) of the pharmacists have above average score of practice. Nearly all the pharmacists who participated have a positive attitude in relation to DAwP (n = 1204, 98.9%). More than half of the pharmacists were DAwP for tonsillitis (n = 817, 67%), wound infection (n = 766, 62.9%), and urinary tract infection (n = 664, 54%). The leading factor behind DAwP was the low socioeconomic status of the patients (n = 624, 51%). Additionally, 47% of the pharmacists (n = 572) thought that they were knowledgeable enough to DAwP. Conclusion Despite their positive attitude and average level of knowledge regarding DAwP, Sudanese community pharmacists frequently are DAwP for tonsillitis. Low patients’ socioeconomic status was the leading factor behind DAwP. Accordingly, extensive work from health authorities to improve the accessibility and affordability of the health system as well as the development of an antibiotic stewardship program are required to diminish DAwP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitude and Practice of Community Pharmacists in Relation to Dispensing Antibiotics Without Prescription in Sudan: A Cross-sectional Study

Hussain¹,

Mohamed²,

Abkar³

et al. 2022

IPRP

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“…Resistance to amoxicillin-clavulanic acid, amikacin, cefepime, cefotaxime, ceftriaxone, cefuroxime, cipro oxacin, gentamycin, meropenem, and trimethoprimsulfamethoxazole was signi cantly higher in Syria than in Ethiopia. However, resistance to nitrofurantoin was slightly higher in Ethiopia [30].…”

Section: Discussionmentioning

confidence: 83%

Antibiotic sensitivity pattern of bacterial pathogens in two tertiary care hospitals in Damascus, Syria: A cross-sectional study

Abdelwahed¹,

Jassem²,

Kakaje

et al. 2022

Preprint

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Background Antibiotics resistance is a major concern as it renders antibiotics ineffective, which would have disastrous effects on patient care. The contribution of the Middle Eastern countries in limiting antimicrobial resistance is diminished due to instability and deteriorating healthcare infrastructure. This study aims to report on the antimicrobial resistance pattern in two tertiary care hospitals in Damascus, the capital of Syria in bloods, sputum, urine and others. Methods A cross-sectional study based on reports of bacterial cultures was performed between April and November in 2020 in microbiology labs of Damascus Hospital and Al-Razi Hospital. Identification of bacteria was performed using standard microbiological procedures. Susceptibility testing was performed using disk diffusion method. Interpretation of the results was done according to the guidelines of the Clinical and Laboratory Standard Institute. Data were analyzed using the statistical package for social sciences version 26. Results 412 cultures were positive for pathogens. Most frequently isolated pathogens were Enterobacter, Staphylococcus aureus, and Escherichia coli. Enterobacter was completely sensitive to doripenem and cefoperazone-sulbactam. The resistance rates of Staphylococcus aureus to vancomycin and linezolid were 23.5% and 24.5%, respectively. Escherichia coli was resistant to ciprofloxacin in 72.4% of samples. Klebsiella pneumonia had shown various resistance rates to all used antibiotics. Females had significantly higher frequency of Escherichia coli, Enterobacter, and Klebsiella pneumoniae in urine samples, while males had significantly higher frequency of Pseudomonas aeruginosa and Proteus mirabilis. Conclusions This study highlighted the high prevalence of antimicrobial resistance in Damascus Hospital and Al-Razi Hospital, two of major hospitals in Damascus. The decreasing potency of antimicrobials is concerning and may require urgent interventions, such as effective surveillance, development of national guidelines for prescribing antibiotics to treat common infections, and awareness campaigns in the community.

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“…Antimicrobial resistance is also on the rise, and there have been instances of hospitalization and mortality as a result of it [ 40 ]. As a result, it is possible that Ethiopia's antimicrobial resistance danger is being exacerbated by the over-prescription of antibiotics [ 41 ]. Antibiotic resistance has a considerable impact on medicine accessibility and healthcare financing in Ethiopia because of the high prevalence of poverty and limited resources [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of private health sector prescribing patterns and adherence to prescription format using World Health Organization core drug use indicators in Addis Ababa, Ethiopia

Asmamaw

Ejigu²,

Tewihubo

et al. 2022

J of Pharm Policy and Pract

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Background Currently, the private healthcare sector's role in healthcare delivery is growing in Ethiopia. However, there are limited studies on private healthcare sector drug use patterns. This study aimed to evaluate the private healthcare sector prescribing practices and adherence to prescription format, using some of the World Health Organization (WHO) core drug use indicators in Addis Ababa, Ethiopia. Methods A retrospective cross-sectional study design was used to collect quantitative data from prescriptions prescribed and dispensed by private healthcare sectors in the Lemi-Kura sub-city, Addis Ababa. The study was conducted from June to July 2021. The WHO criteria were used to evaluate prescribing and prescription completeness indicators. Prescriptions, kept for the last 1 year that were prescribed between January 1, 2020, to January 1, 2021, by private drug outlets, were analyzed. Simple random and systematic sampling procedures were employed in selecting drug outlets and prescriptions, respectively. Results Of a total of 1,200 prescriptions, 2,192 drugs were prescribed and the average number of drugs per prescription was 1.83. Generic names, antibiotics, injections, and drugs on the Ethiopian essential medicines list accounted for 77.4, 63.8, 11.5, and 80.6% of all prescriptions, respectively. Among the patient identifiers, the patient card number (54.3%), weight (2.3%), and diagnoses (31.7%) were less likely to be completed. In terms of the drug-related information, the dosage form (35.5%) was the least likely to be completed. Only 36.6 and 25.8% of prescriptions contained the names and qualifications of the prescribers, respectively. It was difficult to obtain prescription papers with the dispenser identifier. Conclusion The study findings indicated prescribing and prescription completeness indicators all considerably deviated from WHO standards and hence unsuitable. This situation could be critical since a similar pattern is reported from public healthcare sectors, which might imply the extent of non-adherence to WHO core drug use standards. Consequently, it could play a considerable role in increasing irrational medicine use in Ethiopia.

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Prevalence of antimicrobial resistance and its clinical implications in Ethiopia: a systematic review

Cited by 33 publications

References 26 publications

Knowledge, Attitude and Practice of Community Pharmacists in Relation to Dispensing Antibiotics Without Prescription in Sudan: A Cross-sectional Study

Knowledge, Attitude and Practice of Community Pharmacists in Relation to Dispensing Antibiotics Without Prescription in Sudan: A Cross-sectional Study

Antibiotic sensitivity pattern of bacterial pathogens in two tertiary care hospitals in Damascus, Syria: A cross-sectional study

Assessment of private health sector prescribing patterns and adherence to prescription format using World Health Organization core drug use indicators in Addis Ababa, Ethiopia

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