ASSESSMENT OF ANTIBIOTICS PRESCRIPTION PATTERN AND ASSOCIATED FACTORS AMONG PATIENTS ADMITTED TO MEDICAL WARD OF ASELLA REFERRAL AND TEACHING HOSPITAL SOUTHEAST, ETHIOPIA

Abstract

ABSTRACTS Background: Antibiotics are vital for treating bacterial infections and reducing morbidity and mortality worldwide. However, widespread misuse and inappropriate prescribing have led to significant antibiotic resistance. In response, the WHO and national health authorities promote antimicrobial stewardship to optimize antibiotic use. Generating local evidence on prescribing practices is crucial for developing context-specific stewardship interventions. This study assessed antibiotic prescribing patterns and associated factors among patients admitted to the medical ward of Asella Referral and Teaching Hospital, Southeast Ethiopia. Objective: To assess antibiotics prescription pattern and identify factors associated with inappropriate antibiotic use among patients admitted to medical ward of Assela Referral and Teaching Hospital Methodology; An institution-based retrospective cross-sectional study was conducted at Assela Referral and Teaching Hospital medical ward. A total of 228 patient charts were reviewed in the study period. Data analysis was done using SPSS version 27. Descriptive statistics were performed to show the prevalence and frequencies of the collected variables. Those variables that show associations with the dependent variable at p <0.25 in the bi-variate analysis were entered into the multiple logistic regression. Adjusted odds ratios with their corresponding 95% confidence intervals and p-values were used to assess the strength of the associations. Variables with p-values of less than 0.05 in the multiple regressions were finally considered as statistically significant. Result: Of the 228 patient records reviewed, 50.9% were male, and 54.8% were aged 31–64 years. Community acquired pneumonia was the most common diagnosis (20.6%). Ceftriaxone was the most frequently prescribed antibiotic (22.8%) of all prescriptions. Overall, 33% of participants received inappropriate prescriptions. In multivariable logistic regression, patients who do not have culture result show significant rate of inappropriate prescription pattern (AOR = 8.79; 95% CI: 1.98–39.05). Receiving two or more antibiotics was independently associated with higher odds of inappropriate prescription (AOR = 2.42; 95% CI: 1.15–5.10) and patients whose antibiotics was not de-escalated were associated with inappropriate antibiotics use (AOR = 2.40; 95% CI: 1.01–5.70). Conclusion: One third of antibiotic prescriptions for medical inpatients were inappropriate. Culture result, Receiving two or more antibiotics and antibiotics de-escalation were independently associated with higher odds of inappropriate prescription. These findings highlight the need for routine antimicrobial stewardship interventions, prescriber education, and evidence based antibiotics treatment. Key words: antibiotic prescribing pattern; inappropriate antibiotic use; medical ward; WHO prescribing indicators; Ethiopia