ASSESSMENT OF APPROPRIATENESS OF ANTIBIOTICS PRESCRIPTION FOR THE MANAGEMENT OF ACUTE DIARRHEA AND ASSOCIATED FACTORS AMONG UNDER-FIVE CHILDREN IN GONDAR TOWN HEALTH CENTERS, NORTHWEST ETHIOPIA

Abstract

ABSTRACT Background: Acute infectious diarrheal disease is common public health problem worldwide. It is the second leading cause of mortality in under-five children. It accounts 1.8 million deaths annually. There is estimation that 20-50% of antibiotics prescription is inappropriate which results in an increased risk of side effect, higher rates of antimicrobial resistance to enteric pathogens, inappropriate patient demand, and increase health care cost. Factors that influence appropriateness of antibiotics use for management of acute diarrhea are the insufficient number of qualified and competent staffs, care giver preference, experience of the prescriber, patient load, age of the child, lack of continuing medical education and supervision. Objective: To assess the appropriateness of antibiotics prescription for the treatment of acute diarrhea among under-five children in Gondar town health centers. Methods: The study design was institution based cross-sectional type. Data was collected by reviewing the charts/records of under five children treated in health centers from September, 12, 2015 to September, 10, 2016. Result: At least one antibiotic was prescribed for 66.2% of children who attended the health centers. The overall proportion of appropriate prescription of antibiotics for acute diarrheal management in this study was 46.4 % and Trimethoprim Sulfamethoxazole was the main antibiotic inappropriately prescribed. Antibiotics prescription was higher in children presenting diarrhea with fever plus vomiting plus cough compared to child presenting with only diarrhea (p<0.001). prescriber having experience more than 26 years prescribe appropriate antibiotics more likely than prescriber having less than five years of experience (p<0.001). Conclusion and recommendation: the findings of this study show that less than half of the children received appropriate antibiotics prescription for treatment of acute diarrhea. The finding highlights need efforts to reduce the rate of inappropriate antibiotic prescription for the management of diarrhea in children should be made by health professionals through consistent use of national and international guidelines. Key words: Appropriateness of antibiotics, diarrhea in children, acute diarrhea, Health Centers, Ethiopia