Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study
Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study
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DOI：
10.1186/s13756-019-0620-5
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发表时间：
2019-10-22
影响因子：
5.5
通讯作者：
Tesfamariam, Eyasu H.
中科院分区：
文献类型：
--
作者：
Amaha, Nebyu Daniel;Weldemariam, Dawit G.;Tesfamariam, Eyasu H.
背景抗生素需要比其他药物更谨慎的处方，分发和管理，因为这些药物的抗菌素耐药性（AMR）风险更大。研究目前的药物使用实践和影响抗生素处方的因素将有助于决策者起草政策，使药物的使用更加合理。方法前瞻性，描述性和横断面研究进行了评估，目前处方的做法，包括在阿斯马拉的六个社区药房抗生素的使用。在2019年5月5日至5月12日期间，使用分层随机抽样技术，使用WHO核心处方指标，共审查了600次就诊。使用IBM SPSS（R）（版本22）进行描述性统计和逻辑回归。结果平均每张处方用药量为1.76种，83.14%的药品使用通用名，98.39%的药品来自国家基本药物目录（NEML）。含抗生素处方的比例为53%。包含注射的接触次数为7.8%。在双变量和多变量模型中，患者年龄、性别和处方药物数量与抗生素处方显著相关。15岁以下受试者使用抗生素的可能性约为65岁及以上受试者的3倍（调整后比值比（AOR）：2.93，95%CI：1.71-5）。同样，男性比女性更有可能使用抗生素（AOR：1.57，95%CI：1.10-2.24）。与每次处方一到两种药物的受试者相比，处方三到四种药物的受试者被处方抗生素的可能性高两倍（AOR：2.17，95%CI：1.35-3.5）。药物数量每增加一个单位，抗生素处方的几率就增加2.02个单位（COR：2.02; 95%CI：1.62-2.52）。结论这项研究发现，阿斯马拉社区药房处方抗生素的百分比为53%，与世卫组织建议的值（20-26.8%）有很大差异。此外，接受注射的比例比世卫组织的13.4- 24.0%低7.8%。患者的年龄、性别和药物数量与抗生素处方显著相关。
Background Antibiotics require more prudent prescribing, dispensing and administration than other medicines because these medicines are at a greater risk of antimicrobial resistance (AMR). Studying the current medicine use practices and factors affecting the prescribing of an antibiotic would help decision makers to draft policies that would enable a more rational use of medicines. Methods A prospective, descriptive, and cross-sectional study was conducted to assess the current prescribing practices including antibiotics use in six community pharmacies in Asmara. A total of 600 encounters were reviewed using the WHO core prescribing indicators between May 5 and May 12, 2019 using stratified random sampling technique. Descriptive statistics and logistic regression were employed using IBM SPSS (R) (version 22). Results The average number of medicines per prescription was 1.76 and 83.14% of the medicines were prescribed using generic names while 98.39% of the medicines were from the National Essential Medicines List (NEML). The percentage of prescriptions containing antibiotics was 53%. The number of encounters containing injections was 7.8%. Patient age, gender and number of medicines prescribed were significantly associated with antibiotic prescribing at bivariate and multivariable models. Subjects under the age of 15 were approximately three times more likely to be prescribed antibiotic compared to subjects whose age is 65 and above (Adjusted Odds Ratio (AOR): 2.93, 95%CI: 1.71-5). Similarly, males were more likely to be prescribed antibiotic than females (AOR: 1.57, 95%CI: 1.10-2.24). Subjects to whom three to four medicines prescribed were two times more likely to be prescribed an antibiotic compared to those who were to be prescribed one to two medicines per encounter (AOR: 2.17, 95%CI: 1.35-3.5). A one-unit increase in the number of medicines increased the odds of antibiotic prescribing increased by 2.02 units (COR: 2.02; 95%CI: 1.62-2.52). Conclusions This study found that the percentage of antibiotics being prescribed at the community pharmacies in Asmara was 53% which deviated significantly from the WHO recommended values (20-26.8%). Furthermore, the percentage of encounters with an injection was 7.8% lower than the WHO value of 13.4-24.0%. Patients' age, gender and number of medicines were significantly associated with antibiotic prescribing.