Patterns of prescribing antibiotics and associated factors at the Jakaya Kikwete cardiac institute (JKCI), Muhimbili National Hospital (MNH) and Muhimbili Orthopedics Institute (Moi)

Abstract

ABSTRACT Background: Worldwide, between 20 to 50% of antibiotics consumption is inappropriate, triggering substantial impact on the rational use of medicines and incidence of adverse drug reactions. Situation analysis on antibiotic use and resistance conducted in June 2015 in Tanzania, indicated that data on antibiotic resistance is scarce and there is evidence of resistance to commonly used antibiotics, such as; Ampicillin, Tetracycline and Trimethoprim-sulfamethoxazole. Therefore, the purpose of this study was to investigate the prescribing patterns as well as rationale of antibiotic prescription and the associated factors at the JKCI, MNH, and MOI. Methods: A cross sectional review of patients records on prescriptions and laboratory results was conducted among patients admitted to JKCI, MNH and MOI between Jul – Sep 2018. Records from Hospital information’s system (Clinical and Laboratory) were retrieved to identify prescriptions patterns as well as associated factors. Analysis was done using Epi Info 7 and Stata 13.0 as needed and logistic regression analysis was deployed to determine factors associated with prescribing pattern. Results: Proportions of antibiotics prescription were found to be 60%, 64% and 72% at JKCI, MN Hand MOI respectively in 1,176 patient’s prescription records studied. Only a total of 54.17%, 5.41% and 76.58% of antibiotics prescription records from JKCI, MNH and MOI were in accordance to the Tanzanian Standard Treatment Guidelines (STG). Laboratory data showed only 3.2% of all antibiotics prescription records had antimicrobial susceptibility tests done distributed as 0.79%, 2.38% and 0% at JKCI, MNH and MOI respectively. Gender, patient’s category, prescriber’s level of education and Hospital facility with AOR of 1.05(95%CI: 0.64 – 1.74), 1.83(95%CI: 1.09 – 3.08), 1.48(95%CI: 0.64 – 3.46) and 0.03(0.19 – 8.13) respectively were found to be significantly associated with antibiotics prescription practices. Conclusion: The findings of this study provide evidence of irrational antibiotics use at JKCI, MNH and MOI. These baseline data on antibiotics prescribing patterns by healthcare providers are useful information on prescribing patterns to medical practitioners, hospital administrators as well as to inform policy makers. In addition, the findings will save as baseline data for further researches on factors contributing to irrational use of medicines.