Hospital-Level Antibacterial Prescribing and Its Completeness in Ethiopia: Did It Adhere to Good Prescribing Practice?
Received 6 September 2020
Accepted for publication 12 October 2020
Published 6 November 2020 Volume 2020:13 Pages 1025—1034
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Mekonnen Sisay,1 Tigist Gashaw,1 Firehiwot Amare,2 Tewodros Tesfa,3 Yohannes Baye4
1Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Microbiology Unit, Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
Correspondence: Mekonnen Sisay
Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box, 235, Harar, Ethiopia
Tel +251 920 21 21 35
Fax +251 256 66 80 81
Background: Antibacterial agents are an integral part of chemotherapy and play a critical role in the prophylaxis and treatment of bacterial infections. However, prescribing errors such as incomplete prescriptions that do not adhere to good prescribing practice have become a contemporary concern in hospitals in resource-limited settings. Therefore, this study aimed to assess antibacterial prescribing and its completeness among prescriptions dispensed at four governmental hospitals in Eastern Ethiopia.
Methods: A cross-sectional study was employed to assess a total of 1308 prescription encounters containing at least one antibacterial agent obtained with simple random sampling from annual antibacterial-containing prescription data of four hospitals. The data were collected retrospectively using a structured checklist.
Results: A total of 2,855 drugs were prescribed from 1308 prescribing encounters with 1496 (52.39%) being antibacterial agents. The name, age, sex, and diagnosis of the patients were written in 1158 (88.3%), 815 (62.31%), 796 (60.58%), and 183 (13.99%) prescriptions, respectively. Besides, the route of administration, strength, duration, quantity, dose, and dosage form of the drug were recorded in 2322 (81.33%), 2118 (74.19%), 1516 (53.10%), 1525 (53.42%), 746 (26.13%) and 563 (19.72%) prescriptions, respectively. Nearly 50% of the prescribing encounters were documented without a prescriber name. Dispenser name and signature were also obtained in less than 10% of the prescriptions. Combining the data of all hospitals, amoxicillin, ceftriaxone, and ciprofloxacin were identified as the top three prescribed antibacterial drugs, whereas diclofenac, paracetamol, and tramadol were the most frequently co-indicated drugs. Regarding the pharmacologic class of antibiotics, penicillins were the most commonly prescribed antibiotics (n = 596, 39.77%) followed by cephalosporins (n = 318, 21.26%) and fluoroquinolones (n=285, 19.05%).
Conclusion: Incomplete information about patient-related factors and major diagnosis, medication regimens, prescribers and dispensers was identified as a potential prescribing error and did not adhere to good prescribing practice. This can be considered as one part of the inappropriate use of antibacterial agents, a driving force for the emergence of antimicrobial resistance. This problem requires immediate and sustained action from the management of the hospitals to ensure the accountability of health professionals involved in the medication use process and to establish antimicrobial stewardship programs in such resource-limited settings.
Keywords: prescribing practice, completeness, antibacterial drugs, Eastern Ethiopia
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