Abstract:
Introduction: high prevalence of antibiotic
prescriptions may contribute to the problem of
antibiotic resistance. Understanding the pattern of
antibiotic prescriptions in a country may inform
monitoring and stewardship activities, which are
crucial in the fight against antibiotic resistance. We
aimed to determine the prevalence and describe the
pattern of antibiotic prescriptions among National
Health Insurance Fund (NHIF) insured patients
receiving treatment at health facilities in Ilala
Municipality, Dar es Salaam, Tanzania. Methods: a
cross-sectional analysis of claim forms of NHIF
insured patients. A data extraction form was used to capture data for September, 2019 submitted to
the Ilala NHIF offices. Results: among 993 insured
patients (mean [±SD] age 36.3 [±23.2] years; 581
[58.5%] females; 535 [53.9%] adults) a total of 357
(46.4%, 95% CI, 42.8-50.0) received an antibiotic
prescription. Of the 357 patients who received an
antibiotic prescription, 71(19.9%) received more
than one antibiotic prescription. The most common
antibiotic prescribed was amoxicillin/clavulanate
(17.1%) followed by amoxicillin (16.5%) whereas
the most commonly prescribed antibiotic class was
the penicillins (51.3%) followed by the
nitroimidazoles (14.0%). Among patients who
received more than one antibiotic, the most
commonly co-prescribed antibiotics were
Ampicillin/Cloxacillin plus Metronidazole (11.4%)
followed by Amoxicillin plus Metronidazole (7.1%).
According to 2019 WHO Access, Watch, Reserve
(AWaRe) Classification of antibiotics, 60.8% of
patients received the access antibiotics, 33.3%
received the watch antibiotics whereas 17.4% of
patients received antibiotics that were not
recommended. No patient received an antibiotic
from the reserve group. Conclusion: the prevalence
of antibiotic prescriptions in Tanzania is high and
some antibiotics not recommended by the WHO are
still prescribed. We recommend revision of the
current Tanzania treatment guideline on antibiotics
to reflect WHO recommendations, and further
research to address local factors influencing
antibiotic prescriptions is warranted.
