WHO/INRUD core prescribing indicators and antibiotic utilization patterns among primary health care facilities in Ilala district, Tanzania
Amosi Kilipamwambu, George M. Bwire, David T. Myemba, Belinda J. Njiro, Mtebe Majigo
Abstract
Abstract Background Antibiotic use requires regular monitoring to prevent emergence of antibiotic resistance. Objectives To assess antibiotic prescribing patterns at health care facilities (HCF) in Ilala district, Tanzania. Methods A 1 year retrospective study was conducted in four HCFs using WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators. Factors associated with antibiotic prescription were analysed using logistic regression model. Results A total of 604 prescriptions were reviewed. Patients had median age (IQR) of 15 (4–31) years with majority having upper respiratory tract infection 33.3% (n = 201), urinary tract infection 31.1% (n = 188) or diarrhoea 21.2% (n = 128). Out of 624 prescribed antibiotics, amoxicillin was the most common (22.7%), followed by ciprofloxacin (13.6%) and metronidazole (11.6%). The studied HCFs had an average of 1.99 medicines prescribed per consultation (reference: 1.6–1.8). Of 1203 medicines prescribed, 51.9% (n = 624) were antibiotics (reference: 20.0%–26.8%). Additionally, 97.6% (n = 609) of the antibiotics appeared on the national essential medicines list, whereby 84.4% (n = 510) were prescribed by generic names (reference: 100%). Patients with peptic ulcers had a 4.4-fold higher chance of receiving antibiotics [adjusted odds ratio (aOR) = 4.4, 95% CI = 1.918–10.13, P = 0.0001] while patients with diarrhoea had a 2.6-fold higher chance of receiving at least one antibiotic (aOR = 2.6, 95% CI = 1.206–5.491, P = 0.015). Conclusions We found inappropriate use of antibiotics in the studied primary HCFs. Antibiotic stewardship programmes should be extended to primary HCFs found in Ilala district.