Evaluation of Ceftriaxone Utilization and Prescriber’s Opinion at Armed Forces Referral and Teaching Hospital, Addis Ababa, Ethiopia

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Addis Ababa University


Antimicrobial therapy demands an initial clinical evaluation of the nature and extent of the infective process and knowledge of the likely causative pathogen(s). This assessment should be supported, whenever practical, by laboratory investigation and its susceptibility to antimicrobial agents appropriate for treatment of the infection. The overuse and inappropriate use of antimicrobials has led to antimicrobial resistance. The aim of this study was therefore to evaluate the appropriateness of ceftriaxone use and prescriber‘s opinion at Armed Forces Referral and Teaching Hospital (AFRTH). A prospective cross-sectional study was conducted by reviewing medication records of patients who received ceftriaxone during hospitalization at AFRTH. Drug utilization evaluation (DUE) methods used were based on standards set forth by standard treatment guideline of Ethiopia 2014, American society of health system pharmacists. The DUE criteria used in this study were indication for use, dose, frequency of administration, duration of treatment, drug-drug interaction (DDI) and culture and sensitivity (C&S) test. Factors affecting inappropriate utilization of ceftriaxone were determined using regression analysis. From a total of 300 patients, 54.3% were males. Ceftriaxone use was empiric in 62.7% cases. The most common indication for ceftriaxone use was surgical prophylaxis (34%). Most patients were dosed as 2 g/day (75.6%). The duration of therapy was found to be long in the range of 2-7 days (54.3%). Maintenance fluids were the most commonly co-administered medications (93.7%). Based on the interviewed physicians, the high utilization rate of ceftriaxone was due to its effectiveness and availability in the hospital. The use of ceftriaxone was appropriate only in 14.4% cases for the justification of use. Empiric and prophylactic treatment were found to have a significant association with inappropriate utilization of ceftriaxone. Majority of inappropriateness was seen with indication of ceftriaxone, duration of therapy and DDI. This may lead to emergence of resistant pathogens, which in turn compromises its effectiveness leading to treatment failure and increased cost of therapy. To avoid this inappropriate utilization of ceftriaxone, prescribers should prescribe by sticking to standard guidelines. Key words: Ceftriaxone, drug use evaluation, antibiotic, rational use



Ceftriaxone; Drug use evaluation; Antibiotic; Rational use