Injection prescribing patterns in public health care facilities in Egypt

Area of Science:

• Pharmacology
• Health Services Research
• Global Health

Background:

• The World Health Organization (WHO) promotes rational drug use, including minimizing unnecessary injections.
• Injections are frequently used in healthcare settings, but their overuse can lead to adverse events and increased costs.
• Understanding injection practices is crucial for improving antimicrobial stewardship and overall drug safety.

Purpose of the Study:

• To assess the frequency and rationale for injection use in Egyptian healthcare facilities.
• To evaluate adherence to WHO core drug use indicators related to injection practices.
• To identify areas for improvement in rational drug prescribing in Egypt.

Main Methods:

• A cross-sectional study involving the review of 1406 prescriptions.
• Data collection from 43 randomly selected hospitals and primary health care clinics across two governorates in Egypt (Upper and Lower Egypt).
• Analysis of injection frequency, types of drugs administered, and potential for oral substitution.

Main Results:

• Injections were administered in 18.1% of patient encounters.
• Anti-infectives (56.9%) and analgesics (13.7%) were the most common parenteral drugs used.
• Injections were more prevalent in hospitals than primary care clinics and in rural compared to urban settings.
• A high proportion (94.7%) of injections could have been substituted with oral formulations.

Conclusions:

• The study reveals a high rate of injection use in Egypt, with a significant potential for substitution with oral medications.
• Findings underscore the need for enhanced enforcement of the essential medicines program to promote rational drug prescribing.
• Interventions targeting healthcare providers and policy implementation are necessary to reduce unnecessary injections and improve drug utilization patterns.