Antimicrobial Use Practice and Associated Factors among Hospitalized Adult Patient at Tikur Anbessa Specialized Hospital: Pave the way for Antimicrobial Stewardship.
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Date
2023
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Addis Ababa University
Abstract
Background: Antibiotic use is frequent in the inpatient context, and approximately 50% of
admitted patients receive at least one antibiotic during their hospital stay. Antimicrobials are
frequently provided inappropriately to 44–97% of hospitalized patients in developing countries.
Objective: The objective of this study was to assess antimicrobial use practices and associated
factors among hospitalized adult patients at Tikur Anbessa Specialized Hospital (internal
medicine, surgery, and gynecology/obstetrics wards), Addis Ababa, Ethiopia.
Method: A hospital-based prospective observational study was conducted from September to
December 2022. A total of 354 participants were recruited for this study. A semi-structured
questionnaire was used to collect the data from medical records and patient interviews. The
collected data were entered to SPSS version 26.0 for analysis. Descriptive statistics and logistic
regression were used for statistical analysis.
Result: Antibiotic use in 144 (45.7%) patients was considered inappropriate with category IIIA
(long duration) being was the most common type of inappropriateness, accounting for 99 (68.7%).
According to Define Daily Dose (DDD) measures the total antibiotic consumed per 100 patients
per day was 4.71 DDD and based on the WHO antibiotic AWaRe stratification, 298 (62.8%)
antibiotics were consumed from the "Watch" and "Reserve" groups. Patients whose age between 25
to 34 years were protective to inappropriate antibiotic use practice (AOR=0.24, 95% CI:(0.06–
0.89), P = 0.03), marital status of divorced (AOR=5.68, 95% CI:(1.6–19.3),P=0.001) and widowed
(AOR=8.91,95%CI:(1.51–52.6),P=0.01), patents who were admitted at internal medicine
(AOR=3.53, 95% CI:(1.04-11.9), P=0.04) and surgical ward (AOR=10.8, 95% CI:(3.59–
32.9), P=0.001) and patients who were hospitalized for 8 to 14 days (AOR=7.0, 95% CI:(1.59–
182.5), P=0.01), for 15 to 21 days (AOR=11.0, 95% CI:(1.2–100.8), P=0.03) and above 22 days
(AOR=10.9,95%CI:(1.17–103.0),P=0.03) were determinants of inappropriate antibiotic usage.
Conclusion: Generally, higher consumption and inappropriate antibiotic use were observed
among hospitalized adult patients in the study area and need prompt antimicrobial stewardship
interventions and stewardship program improvement in the study wards of the Hospital.
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Keywords
Antimicrobial, stewardship, appropriateness, defined daily dose, Tikur Anbessa Specialized Hospital, Ethiopia.