Baseline Assessment of the Current Practice of Antimicrobial Use and Clinical Outcome in the Management of Patients with Pneumonia Admitted to Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Prospective Observational Study
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Date
2018-07
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Addis Ababa Universty
Abstract
Baseline Assessment of the Current Practice of Antimicrobial Use and Clinical Outcome
in the Management of Patients with Pneumonia Admitted to Tikur Anbessa Specialized
Hospital, Addis Ababa, Ethiopia: A Prospective Observational Study
Theodros Fenta,
Addis Ababa University, 2018
Increasing antimicrobial resistance presents a major threat to public health because it reduces
the effectiveness of antimicrobial treatment, leading to increased morbidity, mortality, and
health care expenditure. In spite of the need for new drugs to treat resistant infections, a
growing number of drug companies are withdrawing from new antibiotic research and
development. Therefore, the issue of how we can most effectively utilize these precious
resources calls for urgent action. Hence, the objective of this study was to assess the current
practice of antimicrobial utilization and clinical outcomes in the management of adult
pneumonia at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia and
design a strategy for appropriate intervention. A prospective observational study was
conducted on adult patients with a diagnosis of pneumonia admitted to TASH. A data
abstraction format incorporating self-administered questionnaire were used to gather
information from patient charts and treating physicians. Data was analyzed using SPSS
version 20. Descriptive statistics and logistic regressions were used. P-values of <0.05 were
regarded as significant. Among the total of 200 patients, 52.0% were males and mean age of
the patients was 39.79 (SD±17.76) years. Microbiologically and imaging/radiologically
examined patients were 75 (37.5%) and 122 (61.0%), respectively. The treatment approaches
in almost all patients (99.5%) were empirical. The most commonly used antimicrobial
regimens were Ceftriaxone 1gm BID + Azithromycin 500mg, PO, QD, (30.0%) for
community acquired pneumonia and Vancomycin 1gm BID + Piperacillin/tazobactam 4.5gm
iv QID, (8.0%) for hospital acquired pneumonia and health care associated pneumonia. The
duration of antimicrobial therapy was 12 (SD±5). The clinical outcomes of the patients were
stable 133(66.5%), and in-hospital mortality 37 (18.5%).
In conclusion, antimicrobials were prescribed empirically without sufficient evidence of
indication such as microbiological and radiologic findings.
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Keywords
Antimicrobials, Antimicrobial resistance, Antimicrobial Stewardship, Pneumonia, Tikur Anbessa Specialized Hospital