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Prescribing Pattern of Antibiotics Using WHO Prescribing Indicators Among Inpatients in Ethiopia: A Need for Antibiotic Stewardship Program

Authors Demoz GT, Kasahun GG, Hagazy K, Woldu G, Wahdey S, Tadesse DB, Niriayo YL

Received 21 May 2020

Accepted for publication 21 July 2020

Published 11 August 2020 Volume 2020:13 Pages 2783—2794


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Eric Nulens

Gebre Teklemariam Demoz,1 Gebremicheal Gebreslassie Kasahun,1 Kalay Hagazy,1 Gebremariam Woldu,1 Shishay Wahdey,2 Degena Bahrey Tadesse,3 Yirga Legesse Niriayo4

1School of Pharmacy, Aksum University, Aksum, Ethiopia; 2School of Public Health, Mekelle University, Mekelle, Ethiopia; 3School of Nursing, Aksum University, Aksum, Ethiopia; 4School of Pharmacy, Mekelle University, Mekelle, Ethiopia

Correspondence: Gebre Teklemariam Demoz
School of Pharmacy, College of Health Sciences, Aksum University, Aksum, Ethiopia
Tel +251914031986

Background: Irrational prescribing of antibiotics is a universal public health problem, leading to antibiotic resistance. Understanding the prescribing pattern of antibiotics is crucial to tackling irrational prescription. Yet, comprehensive studies regarding the prescribing pattern of antibiotics among inpatients and the need for an Antibiotic Stewardship Program (ASP) are lacking in Ethiopia. This study aimed to evaluate prescribing patterns of antibiotics and the need for an ASP.
Methods: A hospital-based prospective observational study was carried out from February 2019 to December 2019. This study was conducted among patients admitted to Aksum University Comprehensive Specialized Hospital, Ethiopia. Data were collected using a data abstraction format generated by World Health Organization (WHO) prescribing indicators. Data analysis was carried out using SPSS version 25.0.
Results: A total of 1653 antibiotics were prescribed for 822 inpatients. Overall, 52.3% of patients had at least one oral and/or injectable antibiotic prescribed, for a mean duration of 4.2 (SD=2.3) days. The average number of prescribed antibiotics per patient was 2.01 (SD=1.9). The majority (97.6%) of antibiotics were prescribed by their generic name, and all prescribed antibiotics were from the national Essential Medicine List (EML). Frequently prescribed injectable and oral antibiotics were ceftriaxone (24.5%) and azithromycin (12.9%), respectively. Culture and sensitivity testing were not performed in any of the cases. During the study period, 65.2% of key antibiotics were available in stock.
Conclusion: In this study, more than half of patients were on at least one antibiotic, and all antibiotics were prescribed from the national EML. However, all antibiotics were prescribed empirically. This result shows that the prescribing pattern of antibiotics in the hospital deviates from and is non-compliant with the standard endorsed by WHO. This study provides evidence for the necessity and a way forward for the establishment of an ASP in the hospital that may help to introduce the prescribing of antibiotics with the aid of culture and sensitivity tests, and to develop institutional guidelines.

Keywords: WHO prescribing indicators, prescribing pattern, antibiotic stewardship program, Ethiopia

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