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Background: Inappropriate prescribing of antibiotics is known to be the major driving force for the emergence of antimicrobial resistance. Assessing the rate and patterns of antibiotics prescribing is the first step to optimize their use.
Objective: This study was aimed at assessing the rate and patterns of antibiotics prescribing at primary healthcare facilities in Addis Ababa.
Methods: Health facility-based cross-sectional study was conducted in six public health centers selected from 26 of the health centers that have been providing service for many years in Addis Ababa (first generation of health centers). Data was collected retrospectively from a total of 900 prescriptions and selected medical charts of patients served in the health centers during the year 2016. Data was collected from January 2 - 20, 2017. The collected data was entered and analyzed using EPI Info 7 and SPSS 20, respectively. Descriptive statistics was used to determine frequencies and averages, and multivariate logistics regression (at 95% CI) was used to check the association of patient characteristics and season of prescribing with antibiotics prescribing.
Results: The number of drugs per prescription was 2.00 (95% CI: 1.94, 2.05) and one or more antibiotics were prescribed in 56.0% (95% CI: 52.8,59.2) of the prescriptions with wide variation among the health centers. Antibiotics accounted for 46.0% of the total cost of medicines prescribed. Amoxicillin was the most frequently (44.8%) prescribed antibiotics and URTI was the most common (24.5%) diagnosis for prescribing antibiotics. Most of the antibiotics (94.8%) were prescribed for oral administration. Laboratory investigation was done for only about 25% of the cases for which antibiotics were prescribed. Patient age was shown to have significant association with prescribing of antibiotics, with more antibiotics prescribed for pediatric patients as compared to the elderly.
Conclusion and Recommendations: There is high rate of antibiotics prescribing in the health centers often without evidence which might exacerbate the AMR situation in the country. Interventions targeted at prescribers should be designed and implemented, and further study should be undertaken to evaluate appropriateness of the antibiotics prescribed, and understand the reasons for the high rate of antibiotics prescribing in these group of health centers.
........................................ Thesis available at ACIPH Library |
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