Antimicrobial Use-Related Problems and Predictors among Hospitalized Medical In-Patients in Southwest Ethiopia: Prospective Observational Study
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 imple...
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09.12.2015
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| Abstract | 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.
The aim of this study was to assess antimicrobial use related problems and associated factors among patients admitted at Jimma University specialized hospital.
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.
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.
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. |
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| AbstractList | 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. The aim of this study was to assess antimicrobial use related problems and associated factors among patients admitted at Jimma University specialized hospital. 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. 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. 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. 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. 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.BACKGROUNDThe 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.The aim of this study was to assess antimicrobial use related problems and associated factors among patients admitted at Jimma University specialized hospital.OBJECTIVEThe aim of this study was to assess antimicrobial use related problems and associated factors among patients admitted at Jimma University specialized hospital.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.METHODSA 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.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.RESULTSOut 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.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.CONCLUSIONMost 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. 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. The aim of this study was to assess antimicrobial use related problems and associated factors among patients admitted at Jimma University specialized hospital. 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. 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. 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. 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. |
| Audience | Academic |
| Author | Yadesa, Tadele Mekuriya Angamo, Mulugeta Tarekegn Gudina, Esayas Kebede |
| AuthorAffiliation | Texas Tech University Health Science Centers, UNITED STATES 2 Department of internal medicine, College of public health and medical sciences, Jimma University, Jimma, Ethiopia 1 Department of pharmacy, College of public health and medical sciences, Jimma University, Jimma, Ethiopia |
| AuthorAffiliation_xml | – name: 1 Department of pharmacy, College of public health and medical sciences, Jimma University, Jimma, Ethiopia – name: 2 Department of internal medicine, College of public health and medical sciences, Jimma University, Jimma, Ethiopia – name: Texas Tech University Health Science Centers, UNITED STATES |
| Author_xml | – sequence: 1 givenname: Tadele Mekuriya surname: Yadesa fullname: Yadesa, Tadele Mekuriya – sequence: 2 givenname: Esayas Kebede surname: Gudina fullname: Gudina, Esayas Kebede – sequence: 3 givenname: Mulugeta Tarekegn surname: Angamo fullname: Angamo, Mulugeta Tarekegn |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26649431$$D View this record in MEDLINE/PubMed |
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| Copyright | COPYRIGHT 2015 Public Library of Science 2015 Yadesa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2015 Yadesa et al 2015 Yadesa et al |
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| References_xml | – volume: 163 start-page: 972 issue: 8 year: 2003 ident: ref22 article-title: Unnecessary Use of Antimicrobials in Hospitalized Patients: Current Patterns of Misuse with an Emphasis on the antianaerobic Spectrum of Activity publication-title: Arch Intern Med doi: 10.1001/archinte.163.8.972 – volume: 13 start-page: 277 issue: 3 year: 2007 ident: ref4 article-title: Benchmarking antimicrobial drug use at university hospitals in five European countries publication-title: Clinical Microbiology and Infection doi: 10.1111/j.1469-0691.2006.01613.x – volume: 33 start-page: S78 issue: Suppl 2 year: 2001 ident: ref3 article-title: Maximizing Appropriate Antibiotic Prophylaxis for Surgical Patients publication-title: Clinical Infectious Diseases – volume: 39 start-page: 527 year: 1997 ident: ref13 article-title: Indications for antibiotic use in ICU patients: a one-year prospective surveillance publication-title: Journal of Antimicrobial Chemotherapy doi: 10.1093/jac/39.4.527 – year: 2007 ident: ref21 article-title: Pharmaceutical care practices: the clinician's Guide – volume: 31 start-page: 1561 year: 2012 ident: ref7 article-title: Non-adherence to antimicrobial treatment guidelines results in more broad-spectrum but not more appropriate therapy publication-title: Eur J Clin Microbiol Infect Dis doi: 10.1007/s10096-011-1478-5 – volume: 1 start-page: 1 issue: 2 year: 2010 ident: ref6 article-title: Antibiotic Resistance; Contributing Factors publication-title: JUMDC – volume: 36 start-page: 489 issue: 2 year: 2005 ident: ref8 article-title: Patterns, appropriateness, and predictors of antimicrobial prescribing for adults with upper respiratory infections in urban slum communities of Bangkok publication-title: Southeast Asian J Trop Med Public Health – volume: 73 start-page: 157 year: 2011 ident: ref9 article-title: An assessment of antibiotics prescribed at the secondary health-care level in the Kyrgyz republic publication-title: Nagoya j. med. sci – volume: 11 start-page: 187 year: 2011 ident: ref14 article-title: Unnecessary use of fluoroquinolone antibiotics in hospitalized patients publication-title: BMC Infectious Diseases doi: 10.1186/1471-2334-11-187 – start-page: 33 year: 2007 ident: ref16 article-title: Antibiotic use in two hospitals in west Wollega, Ethiopia – volume: 4 start-page: 5 issue: 1 year: 2002 ident: ref1 article-title: Determinants of Antimicrobial Use in the Developing World publication-title: Child Health Research Project Special Report – volume: 31 start-page: 3 issue: Supl.4 year: 2013 ident: ref5 article-title: Inappropriate use of antibiotics in hospitals: The complex relationship between antibiotic use and antimicrobial resistance publication-title: Enferm Infecc Microbiol Clin doi: 10.1016/S0213-005X(13)70126-5 – volume: 6 start-page: 283 year: 2013 ident: ref10 article-title: Bacterial profile and antimicrobial susceptibility pattern in septicemia suspected patients attending Gondar University Hospital, Northwest Ethiopia publication-title: BMC Res Notes doi: 10.1186/1756-0500-6-283 – volume: 36 start-page: 724 year: 2003 ident: ref23 article-title: Risk Factors for Antibiotic-Resistant Infection and Treatment Outcomes among Hospitalized Patients Transferred from Long-Term Care Facilities: Does Antimicrobial Choice Make a Difference? publication-title: Clinical Infectious Diseases doi: 10.1086/368081 – volume: 14 start-page: e55 year: 2010 ident: ref19 article-title: Inappropriate antimicrobial use in Turkish pediatric hospitals: A multicenter point prevalence survey publication-title: International Journal of Infectious Diseases doi: 10.1016/j.ijid.2009.03.013 – volume: 23 start-page: 167 issue: 2 year: 2011 ident: ref15 article-title: Factors associated with adherence to prophylactic antibiotic therapy for elective general surgeries in Japan publication-title: International Journal for Quality in Health Care doi: 10.1093/intqhc/mzq080 – volume: 4 start-page: 377 year: 2011 ident: ref17 article-title: Medication prescribing errors in the intensive care unit of Jimma University Specialized Hospital, Southwest Ethiopia publication-title: J Multidiscip Healthc – volume: 7 issue: 1 year: 2011 ident: ref20 article-title: Surveillance of antibiotic use and resistance in orthopaedic department in an Egyptian university hospital publication-title: Int J Infect Control – volume: 117 start-page: 1496 year: 2000 ident: ref11 article-title: Rational Empiric Antibiotic Prescription in the ICU publication-title: CHEST doi: 10.1378/chest.117.5.1496 – ident: ref18 – volume: 41 issue: 6 year: 2007 ident: ref12 article-title: Adverse events to antibiotics in inpatients of a university hospital publication-title: Rev Saúde Pública – start-page: 2 year: 2011 ident: ref2 article-title: Continuing Education Discussion Guide |
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| Title | Antimicrobial Use-Related Problems and Predictors among Hospitalized Medical In-Patients in Southwest Ethiopia: Prospective Observational Study |
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