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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Bibliographic Details
Published in:PloS one Vol. 10; no. 12; p. e0138385
Main Authors: Yadesa, Tadele Mekuriya, Gudina, Esayas Kebede, Angamo, Mulugeta Tarekegn
Format: Journal Article
Language:English
Published: United States Public Library of Science 09.12.2015
Public Library of Science (PLoS)
Subjects:
Adolescent
Adult
Aged
Analysis
Anti-Bacterial Agents - therapeutic use
Anti-infective agents
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
Antimicrobial resistance
Charts
Chronic obstructive pulmonary disease
Complications and side effects
Developing countries
Drug resistance
Drug stores
Drugs
Ethiopia
Female
Guidelines
Health aspects
Health surveillance
Hospital patients
Hospitals
Hospitals, University
Humans
Infections
Infectious diseases
Inpatients
Intensive care
LDCs
Male
Middle Aged
Observational studies
Patients
Pharmacy
Pneumonia
Practice Patterns, Physicians
Public health
Regression analysis
Statistical analysis
Studies
Young Adult
Ethiopia
United States > US
ISSN:1932-6203, 1932-6203
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Summary: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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Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: TMY EKG MTA. Performed the experiments: TMY EKG. Analyzed the data: TMY EKG MTA. Contributed reagents/materials/analysis tools: TMY EKG MTA. Wrote the paper: TMY EKG MTA. Edited the manuscript: TMY.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0138385