Infection and Drug Resistance (Apr 2021)

Evaluation of Adult Outpatient Antibiotics Use at Jimma Medical Center (with Defined Daily Doses for Usage Metrics)

  • Melaku T,
  • Gashaw M,
  • Chelkeba L,
  • Berhane M,
  • Bekele S,
  • Lemi G,
  • Wakjira T,
  • Tesfaw G,
  • Mekonnen Z,
  • Ali S,
  • Kroidl A,
  • Wieser A,
  • Froeschl G,
  • Gudina EK

Journal volume & issue
Vol. Volume 14
pp. 1649 – 1658

Abstract

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Tsegaye Melaku,1 Mulatu Gashaw,2 Legese Chelkeba,3 Melkamu Berhane,4 Sisay Bekele,5 Gemechu Lemi,6 Tekle Wakjira,7 Getnet Tesfaw,2 Zeleke Mekonnen,2 Solomon Ali,8 Arne Kroidl,9,10 Andreas Wieser,9,10 Guenter Froeschl,9,10 Esayas Kebede Gudina11 1School of Pharmacy, Jimma University, Jimma, Ethiopia; 2School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia; 3Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia; 5Department of Ophthalmology, Jimma University, Jimma, Ethiopia; 6Department of Surgery, Jimma University, Jimma, Ethiopia; 7Department of Obstetrics and Gynecology, Jimma University, Jimma, Ethiopia; 8Department of Microbiology, Immunology and Parasitology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 9Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany; 10German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany; 11Department of Internal Medicine, Jimma University, Jimma, EthiopiaCorrespondence: Tsegaye MelakuSchool of Pharmacy, Jimma University, Jimma, EthiopiaTel +251 913765609Email [email protected]: Inappropriate antibiotic use is a major public health concern and driver of antibiotic resistance. Excessive exposure to antibiotics results in the emergence and spread of drug-resistant microorganisms. This study aimed to measure the volume of antibiotic consumption at the outpatient settings in a tertiary-care teaching hospital in Ethiopia.Methods: A cross-sectional study was undertaken from February 01, 2019 to March 31, 2019 at Jimma Medical Center in southwest Ethiopia. Antibiotics use was analyzed using Anatomical Therapeutic Chemical Classification and Defined Daily Dose (DDD) system. Antibiotic use was calculated as DDD per 100 outpatients per day. Antibiotics were classified based on World Health Organization “AWaRe” classification scheme as “Access”, “Watch” and “Reserve” group antibiotics and measured their consumption intensity.Results: A total of 496 adult patients were included in the study. The mean (SD) age of participants was 33.07 (14.05) years. The total amount of antibiotics consumed was 5.31 DDD/100 outpatients per day. Ciprofloxacin was the most commonly [122 (21.12%)] prescribed antibiotics with DDD/100 outpatients per day value of 1.13, followed by amoxicillin [68 (11.76%)] with DDD/100 outpatients per day value of 0.44, and azithromycin [61 (10.55%)] with DDD/100 outpatients per day value of 0.51. On antibiotic consumption index, antibiotics in the “Watch” group had 2.10 DDD/100 outpatients per day.Conclusion: There was high consumption of antibiotics in the study setting. Based on the use control criteria, half of the antibiotics used were in the “Watch” group. The high level of consumptions of antibiotics, such as ciprofloxacin, norfloxacin, and azithromycin, in particular, requires further scrutiny and calls for an urgent implementation of an antibiotic stewardship program at the hospital.Keywords: antibiotics, antibiotics consumption, antibiotic resistance, defined daily dose, Ethiopia

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