Appropriateness of Antibiotics Use and Associated Factors in Hospitalized Patients at University of Gondar Specialized Hospital, Amhara, Ethiopia: Prospective Follow-up Study

Background: Appropriate antibiotic use means that the patient receives the appropriate drug at adequate doses and duration for a susceptible pathogen. This improves the effectiveness of antibiotic therapy and prevents the emergence of resistant pathogens. Thus, this study aimed to assess the appropriateness of antibiotics use and associated factors among hospitalized patients.

Methods: A hospital-based prospective follow-up study was conducted in internal medicine. Data were collected by chart review and interview of prescribers and patients using a pre-tested questionnaire derived from RAND modified Delphi method. Appropriate antibiotic use means that the patient receives the drug based on culture result at the right time in adequate doses and duration. Frequencies and percentage distribution of dependent variables were analyzed. Moreover, bivariate and multivariate analyses were used to assess the factors influencing factors.

Result: Of the 303 study participants the mean age was44.36 ± 1.07 years and the majority 173 (57.1%) of the participants were females. The appropriateness of antibiotics use among hospitalized patients was 26 (8.6%). Males have used antibiotics more appropriately than females [5.99 (Adjusted odd ration (AOR) 95% CI 2.00-7.98)], while employed study participants were used antibiotics more appropriately than nonemployees [7.29 (AOR 95% CI 1.34-9.58)]. Moreover, patients who received antibiotics after blood culture [2.74 (AOR 95% CI 1.09-8.37)] and cerebrospinal fluid culture [5.82 (AOR 95% CI 1.84-5.63)] were used antibiotics more appropriately than patients who received antibiotics without culture. In addition, patients who believe that the prescribed antibiotics prevent complication of the disease [4.21 (AOR 95% CI 1.33-7.35)] were used antibiotics more appropriately than those who didn't understand the use of antibiotics.

Conclusion: The appropriateness of antibiotics use was very low in the study area. Patient gender, ethnicity, source of income, patient's belief in antibiotics, and specimen cultures were significantly associated with the appropriateness of antibiotics use.