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. 2024 Sep 26;6(3):174-184.
doi: 10.36519/idcm.2024.394. eCollection 2024 Sep.

Antimicrobial Use Among Outpatients at Benjamin Mkapa Hospital in Dodoma Central Zone of Tanzania: A Prospective Descriptive Study

Kauke Bakari Zimbwe  1 , Yusto Julius Yona  1 , Charity Alphonce Chiwambo  2 , Devis Antony Mhagama  3 , Alphonce Bilola Chandika  4 , Humphrey Sawira Kiwelu  5 , Reuben Sunzu Mkala  6 , Omary Salim Kizenga  7 , Mfaume Michael Mleke  1 , Moshi Moshi Shabani  8
Affiliations

Antimicrobial Use Among Outpatients at Benjamin Mkapa Hospital in Dodoma Central Zone of Tanzania: A Prospective Descriptive Study

Kauke Bakari Zimbwe et al. Infect Dis Clin Microbiol. .

Abstract

Objective: Irrational antimicrobial use (AMU) has led to an exponential increase in antimicrobial resistance (AMR) in hospitals and communities, which creates challenges in treating infectious diseases caused by bacteria. This study aimed to evaluate antimicrobial prescriptions and usage patterns for treating bacterial infections among outpatients at Benjamin Mkapa Hospital (BMH).

Materials and methods: A prospective descriptive study design was used to evaluate the AMU trend. The data were collected from August 2022 to October 2022 from outpatient pharmacies at BMH using the World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) indicators. The simple random sampling method was employed to select the prescriptions. The WHO AWaRe (Access, Watch, and Reserve) classification was used to classify common antimicrobials. We analyzed the prevalence of outpatient AMU, including the types of antimicrobials, indications, and compliance with treatment guidelines. We also examined the number of antimicrobials per prescription and the adherence to drug use.

Results: We examined 1557 prescriptions, 406 (26.1%) (WHO recommendation 20.0-26.8%) of which included antimicrobials. All prescriptions with antimicrobials were written in generic names, drug utilization-90% (DU90%) was 100% (WHO recommendation 100%). The number of parenteral antimicrobials prescribed was 79 (19.5%) (WHO recommendation 13.4-24.1%). Furthermore, prescriptions with antimicrobials that complied with the current Standard Treatment Guidelines and National Essential Medicine List in Tanzania (STG/NEMLIT) were 369 (90.9%) (WHO recommendation 100%). Most antimicrobials were prescribed as monotherapy, accounting for 265 (65.3%). There were 1.4 (WHO recommendation 1.6-1.8) antimicrobials per prescription. Our study identified 21 commonly prescribed antimicrobials, whereby 9 (42.9%) (WHO recommendation >60%) antimicrobials were Access, 10 (47.6%) (WHO recommendation <20%) Watch, and 2 (9.5%) (WHO recommendation <1%) Reserved classes.

Conclusion: Our study showed that BMH has optimal practices for prescribing and using antimicrobials for outpatients. It further underlined the need to expand and strengthen antimicrobial stewardship efforts to reinforce prescribing antimicrobials.

Keywords: AWaRE classification; WHO/INRUD indicators; antimicrobial resistance; antimicrobial stewardship; antimicrobial use; antimicrobials.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A flow chart showing a sampling of prescriptions from EMD and OPD pharmacies.
Figure 2
Figure 2
Age group description of prescriptions surveyed (N=1557).
Figure 3
Figure 3
Illustration of classes of antimicrobial prescribed for outpatients.
See this image and copyright information in PMC

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