Evaluation of Antibiotics Use and its Predictors at Pediatrics Ward of Jimma Medical Center: Hospital Based Prospective Cross-sectional Study

Abstract

Background: One of the biggest emerging public health issues is the alarming increase in the prevelance of antibiotic resistance across the globe, which is linked to significant morbidity and mortality and demands special attention. The most significant risk factor for antimicrobial resistance (AMR), which is increasing considerably in Ethiopia and is responsible for increased adverse effects, treatment failure, and rising health-care costs, is inappropriate antibiotic usage. The purpose of this study was to assess the use of antibiotics in inpatient settings at an Ethiopian teaching hospital providing tertiary care. Methods: The hospital-based prospective cross-sectional study was undertaken at JMC in southwest Ethiopia. Data were collected by using structured checklist which contains patient’s sociodemographic characteristics and pattern of antimicrobial use. All cards of patients which fulfill the inclusion criteria were selected by using a systematic random sampling technique. Bivariate analysis was done to know the association between independent variable and the outcome variable. Results: The medical records of 402 pediatric patients who had taken at least one systemic antibiotic were examined. The most frequently prescribed combination antibiotics were ampicillin+gentamycin (43.33%) followed by ceftriaxone+gentamycin (15.23%). Gentamycin 116 (24.11%) was the most frequently used antimicrobial. Overall 19.29% of antibiotic use was improper. A higher percentage of participants 149 (22.41%) experienced inappropriate antibiotic usage as a result of inappropriate frequency. Pediatric patients stay in hospital ≥7 days (AOR; 2.45, 95%CI: 2.32–5.34), prescribed antibiotics ≥2 3.12 (AOR: 3.12, 95%CI: 6.32–13.37) and prescribed empirical treatment types (AOR; 2.65, 95%CI: 4.23–8.87) were independent predictors of inappropriate antibiotics use. Conclusion: Antibiotics were generally used inappropriately at high rates. Gentamycin and crystalline penicillin were the most prescribed antibiotics. Longer hospital stay, antibiotics prescription ≥2, and empirical treatments were the independent predictors of inappropriate antibiotic use.