Infection and Drug Resistance (Jan 2021)
Amoxicillin Utilization Pattern at Governmental Hospitals in Eastern Ethiopia
Abstract
Tigist Gashaw,1 Mekonnen Sisay,1 Tewodros Tesfa,2 Yohannes Baye,3 Firehiwot Amare4 1Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Microbiology Unit, Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Tigist GashawDepartment of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, EthiopiaEmail [email protected]: Penicillin is among the highly used antibiotics in most parts of the world, with amoxicillin being the most frequently utilized drug in the category. However, amoxicillin use has been found to deviate from standard treatment guidelines (STGs).Objective: This study aimed to evaluate amoxicillin utilization patterns based on Ethiopian STGs criteria at four governmental hospitals in Harar town: Hiwot Fana Specialized University Hospital, Jugel Hospital, South East Command III Hospital, and Federal Harar Police Hospital in Eastern Ethiopia in 2016.Methods: A hospital-based retrospective cross-sectional study was employed using medication records of patients who received amoxicillin in 2016 at four governmental hospitals from May 15 to June 30, 2018. A total of 502 medication records were proportionally allocated based on the ratio of consumption data of each hospital. Simple random sampling was employed to collect the required sample from the sampling frame. The collected data were entered into SPSS version 21 and analyzed using descriptive analysis.Results: Amoxicillin was used in all age groups, including pregnant and lactating women. The majority (96.2%) of patients were from the outpatient departments. Complete blood count was the most laboratory investigation carried out in 24.9% whereas microbiological culture was not recorded at all. Top three indications include nonspecific upper respiratory tract infections (15.1%), pneumonia (13.5%) and dental problems (10.6%). Non-steroidal anti-inflammatory drugs (56.2%) were frequently co-administered agents. An appropriate utilization was made considering indication, dose, frequency and therapy duration in 23.9% as per the Ethiopian STG. The wrong indication (65.4%) was the prime reason for inappropriateness, followed by dose (14.6%) and duration of therapy (12.2%).Conclusion: Amoxicillin utilization was appropriate in less than a quarter of patients. The wrong indication was the main reason for inappropriateness, predisposing to resistance development. Further studies identifying factors related to misuse and sensitivity tests should be the next steps.Keywords: amoxicillin, utilization, antibiotics, resistance, appropriateness
