Assessment of ceftriaxone utilization in different wards of the Federal Police Referral Hospital in Ethiopia: a retrospective study

Abstract

The unreasonable use of certain antimicrobials is one of the threatening issues worldwide leading to evolving antimicrobial resistant bacteria species. The problem becomes twofold when it occurs in low income countries like Ethiopia. The objective of this study was to assess the utilization of ceftriaxone in different wards of the Federal Police Referral Hospital (FPRH), Addis Ababa, Ethiopia. An institution based retrospective cross sectional study design was used to evaluate the use of ceftriaxone. The assessment was done by reviewing medication records of patients who received ceftriaxone during hospitalization in the different wards of FPRH from 01May, 2013 to 30 April, 2014. A systematic random sampling technique was used to select the samples from all the inpatient prescriptions containing ceftriaxone. Data was collected by using a structured format and evaluated against the standard treatment guideline of Ethiopia as well as the Infectious Disease Society of America and American Society of Health-System Pharmacists’ guidelines. Out of the 682 patient medication records sampled, 571 were found to be complete and subsequently evaluated against the guidelines. Ceftriaxone was prescribed for 2048 (44.3%) of the 4423 admissions in the respective wards. Overall evaluation of ceftriaxone therapy for indication, dose, frequency and duration revealed that 346 (60.6%) of the patient medication records were compliant to recommendations set in the guidelines. Among the co-prescribed medications; warfarin, heparin and doxycycline with potential drug-drug interaction with ceftriaxone were found to be concomitantly used. Days of hospital stay, type/payment scheme of medical service and type of ward patients who had been admitted in were the factors associated with compliant ceftriaxone use in FPRH. The compliance of ceftriaxone utilization in FPRH to the guidelines, is moderate. All concerned bodies and the hospital should develop an antimicrobial use guideline and provide ongoing trainings to promote rational use of antimicrobials including ceftriaxone.

Keywords: ceftriaxone utilization, retrospective study, random sampling, Federal Police Referral Hospital, Ethiopia