Antimicrobial use, prescribing quality, and therapy-related problems among hospitalized patients in Northeast...

Antimicrobials are the leading drug class implicated in drug therapy problems (DTPs). In Ethiopia, comprehensive evidence on antimicrobial-related DTPs in high-risk hospital settings such as medical, surgical, and intensive care units (ICUs) is limited. Inappropriate prescribing in these wards can lead to serious clinical consequences. This study assessed the prevalence of antimicrobial-related DTPs, predictors, and prescribing quality of antimicrobials among hospitalized adult patients in Northeast Ethiopia.

This study employed a hospital-based cross-sectional design with prospective data collection from August 12 to October 30, 2024, at Dessie and Woldia Comprehensive Specialized Hospitals. A total of 334 adult inpatients were consecutively and proportionally enrolled. Data were collected using structured checklists, patient interviews, and medical record reviews. Epi Info version 7.2 and SPSS version 27 were used for data entry and analysis. Descriptive statistics summarized patient characteristics and antimicrobial use. Logistic regression identified predictors of antimicrobial-related DTPs, with statistical significance set at p < 0.05.

This study was conducted in two hospitals and involved a total of 334 patients, of whom 65% were male. Overall, 83.5% experienced at least one antimicrobial-related DTP. The most frequent was a subtherapeutic dose (72.8%), while ineffective antimicrobial therapy was the least common (5.4%). Safety and adherence-related problems each affected 23.4% and 70.4% of patients, respectively; effectiveness-related issues occurred in 75.4%, and indication-related problems in 74.3%. Binary logistic regression analysis identified independent predictors of antimicrobial-related DTPs, including use of 3-6 medications (AOR = 8.39, 95% CI: 3.53-18.41, p < 0.001), use of ≥6 medications (AOR = 3.49, 95% CI: 1.32-9.23, p = 0.01), and care provided by Intern (AOR = 4.39, 95% CI: 1.27-15.15, p = 0.02). Documentation of antimicrobial prescribing was frequently incomplete: treatment duration was absent in 99.4% of cases, prophylactic indications in 84.1%, and stop/review dates in 53.0%.

Antimicrobial-related DTPs were common among hospitalized adults in Northeast Ethiopia. Polypharmacy and prescriber qualification were identified as key contributing factors. These findings underscore the need to strengthen antimicrobial stewardship initiatives and promote rational prescribing practices to mitigate DTPs and enhance patient safety.