Appropriateness of Antibiotics use and associated factors among Hospitalized Patients in internal medicine ward, University of Gondar Specialized Hospital, Amhara region, Ethiopia. Prospective follow up study

Abstract

Abstract Background: Appropriateness of antibiotics use involves determining the need, and timing of adequate antibiotics in indication and dose, which measured by content and quality of prescribing decisions for the individual patient. Usually prescribers expected to be prescribing appropriately, but clinical decisions to initiate and choosing properly may be challenging, especially in developing countries where poor diagnostic test and availability. Objective: This was to asses’ appropriateness of antibiotics use and associated factors in the hospitalized patients. Methods: Hospital based prospective follow up study was conducted in Internal medicine ward (IMW), at UGSH. Data was collected by chart review and prescriber interview using a pretested questionnaire derived from RAND modified Delphi method. The data was assessed, cleaned, entered to Epi info 7 and analyzed using SPSS, version 20. Descriptive statistics and Binary logistic regression was applied to show the association. Result: The mean age of patients were 44.36+1.07 years. About 57.1% patients were females. The appropriate antibiotics use was low 26 (8.6%). Male patients were 5.9 times more appropriate than females patients (AOR 95% CI 5.90(1.43-24.28), p<0.02). Merchant patients had received antibiotics 13 times more appropriate than students and daily labor patients 12.98(AOR 95% CI 1.34-125.40). Specimens of blood 23.81 times and cerebrospinal fluid 23.75 times more appropriate than patients received without any specimen for confirmation of diagnosis 23.81(4.68-121.07) and 23.75(5.60-100.74) respectively. Prescribing antibiotics according to the national guideline increases 4.34 times appropriate than patients receiving antibiotics according to IDSA guideline and expert opinion. Conclusion: The appropriateness of antibiotics use was very low. Male patients used antibiotics more appropriately than females. A patient with specimen for culture or gram stain had significantly increased use of appropriate antibiotics. Patients work as a merchants and with free medical service had more appropriate antibiotics use. Prescribing antibiotics according to the national guideline increased the coverage of likely pathogens and appropriateness of antibiotics. Keywords: Appropriateness of antibiotics, infectious disease, factors, internal medicine, University of Gondar, Ethiopia