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Antimicrobial Use-Related Problems and Predictors among Hospitalized Medical In-Patients in Southwest Ethiopia:
Tadele Mekuriya Yadesa1, Esayas Kebede Gudina2, Mulugeta Tarekegn Angamo1
1Department of pharmacy, College of public health and medical sciences, Jimma University, Jimma, Ethiopia.
Background:
The spread of antimicrobial resistance in developing countries is associated with complex and interconnected factors, such as excessive and unnecessary prescribing of antimicrobials, increased self-prescribing by the people and poor quality of available antimicrobials. Moreover, the failure to implement infection control practices and the dearth of routine susceptibility testing and surveillance magnify the problems. This may spread the inappropriateness of prescribing, ending up with the spread of antimicrobial resistance.
Objective:
The aim of this study was to assess antimicrobial use related problems and associated factors among patients admitted at Jimma University specialized hospital.
Methods:
A hospital based prospective observational study design was employed at medical wards of Jimma University specialized hospital, Ethiopia. Data collected from patient medication charts and from the patients was analyzed using SPSS, version 16.0. Logistic regression was used to determine the associations between variables. Statistical significance was considered at p-value <0.05.
Results:
Out of 152 study participants, at least one antimicrobial use problem was identified among 115(75.7%). Accordingly, additional antimicrobials were needed by 45(29.6%) of the patients, whereas they were unnecessary among 44(28.9%). Similarly, 17% of the patients were noncompliant to at least one antimicrobial therapy, while 8.6% experienced at least one type of adverse drug reaction. On the other hand, the coverage of the infectious medical condition in the national guidelines (AOR = 4.888) and the duration of hospital stay (AOR = 3.086) were the determinants of the antimicrobial use problems.
Conclusion:
Most of the antimicrobial use problems identified were related to delay of initiation of effective antimicrobials and excessive use; use without indication or using duplicates of broad spectrum antimicrobials or use for longer duration than recommended. The coverage of the infectious medical condition in the national treatment guidelines and the duration of hospital stay were the determinants of the antimicrobial use problems.
Insights
Antimicrobial use problems are common in developing countries, affecting 75.7% of patients. National guidelines and hospital stay duration significantly influence these issues, highlighting the need for better antimicrobial stewardship.
Area of Science:
- Clinical Pharmacy
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance is a growing global threat, exacerbated in developing nations by factors like over-prescription, self-medication, and poor drug quality.
- Inadequate infection control and lack of surveillance further compound the problem, leading to widespread inappropriate antimicrobial prescribing.
Purpose of the Study:
- To evaluate problems associated with antimicrobial use.
- To identify factors contributing to antimicrobial use problems among hospitalized patients at Jimma University Specialized Hospital.
Main Methods:
- A prospective observational study was conducted in the medical wards of Jimma University Specialized Hospital, Ethiopia.
- Data were collected from patient medication charts and direct patient interviews.
- Statistical analysis, including logistic regression, was performed using SPSS version 16.0 to identify determinants of antimicrobial use problems.
Main Results:
- At least one antimicrobial use problem was identified in 75.7% of the 152 study participants.
- Common issues included delayed initiation, excessive use, unnecessary prescriptions, and prolonged duration of antimicrobial therapy.
- National treatment guideline coverage (AOR=4.888) and length of hospital stay (AOR=3.086) were significant determinants of antimicrobial use problems.
Conclusions:
- A high prevalence of antimicrobial use problems exists, often linked to inappropriate prescribing practices.
- Adherence to national treatment guidelines and optimizing hospital stay duration are crucial for mitigating antimicrobial use problems.
- Improved antimicrobial stewardship programs are essential to combat antimicrobial resistance in this setting.
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