WHO/INRUD prescribing indicators among tertiary regional referral hospitals in Dar es Salaam, Tanzania: a call to strengthen antibiotic stewardship programmes.
JAC Antimicrob Resist
; 5(4): dlad093, 2023 Aug.
Article
em En
| MEDLINE
| ID: mdl-37546545
ABSTRACT
Background:
Antibiotic prescribing should be guided by national essential medicines lists (NEMLs) and treatment guidelines; however, there are inadequate data on antibiotic utilization patterns in tertiary hospitals in Tanzania. This study aimed to determine antibiotic prescribing patterns in tertiary hospitals in Dar es Salaam, Tanzania.Methods:
A retrospective cross-sectional study was conducted in three regional referral hospitals. About 200 prescription records from 2020 to 2022 were analysed at each hospital for prescribing patterns using WHO/ International Network of Rational Use of Drugs (INRUD) indicators (1993) and the AWaRe 2021 classification. Factors associated with receiving an antibiotic prescription were assessed using a logistic regression model. Facilities were ranked on prescribing practices using the index of rational drug prescribing (IRDP).Results:
A total of 2239 drugs were prescribed, of which 920 (41.1%) were antibiotics. An average of 3.7â±â1.5 (optimal 1.6-1.8) total medicines and 1.53â±â0.78 antibiotics were prescribed per patient. About 88.0% (528) of the prescriptions contained antibiotics (optimal 20.0%-26.8%), while 78.2% (413) of all antibiotic prescriptions contained injections (optimal 13.4%-24.1%). Furthermore, 87.5% (462) of the antibiotics were prescribed in generic names (optimal 100%), while 98.7% (521) conformed to the NEML (optimal 100%). Metronidazole was the most frequently prescribed antibiotic (39.2%; nâ=â134), followed by ceftriaxone (37.1%, nâ=â127) and amoxicillin/clavulanic acid (8.5%, nâ=â29).Conclusions:
We found substantial empirical prescribing and overuse of antibiotics exceeding WHO recommendations. Antibiotic overuse varied across the hospitals. Being male, having underlying conditions such as diabetes mellitus, and/or being treated at Temeke hospital were associated with receiving an antibiotic prescription. We recommend strengthening antibiotic stewardship programmes in the studied facilities.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article