Shimels Tariku, Bilal Arebu I, Mulugeta Anwar
Federal Police Commission Health Services Directorate, Addis Ababa, Ethiopia.
Departement of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia.
J Pharm Policy Pract. 2015 Nov 9;8:26. doi: 10.1186/s40545-015-0047-1. eCollection 2015.
The irrational use of reserved antimicrobials, such as ceftriaxone, is one of the global public health issues particularly to low income countries like Ethiopia, leading to high costs of treatment or therapeutic failure. The purpose of the present study, thus, is to evaluate the appropriateness of ceftriaxone utilization in the medicine wards of general hospitals in Addis Ababa, with reference to the standard treatment guideline of Ethiopia for general hospitals.
An institution based retrospective cross sectional study design was conducted in the internal medicine wards of Hayat and Zewditu Memorial hospital from 20 January to 20 February, 2014. Medication records of all patients who were admitted and prescribed with ceftriaxone during the previous one year to the study period were evaluated in reference to the Ethiopian Standard Treatment Guideline (STG 2010) for general hospitals.
The proportion of patients who received ceftriaxone was 59.3 % and 49 % in the public & the private hospital, respectively. Pneumonia, meningitis and sepsis were the common diagnoses in which ceftriaxone was prescribed in both hospitals. Maintenance fluids were the top ranked co-prescribed drugs in either hospital. Only 48.9 % in the public hospital and 44.6 % of records in the private hospital showed overall ceftriaxone use compliance to the guideline. Days of hospital stay was associated with appropriateness of ceftriaxone therapy.
Even though ceftriaxone is one of the most commonly prescribed drugs in both hospitals, appropriateness of its use, according to the Ethiopian standard treatment guideline, was less than expected. This was so mainly from its indication and duration of therapy. Increasing the duration of hospital stay, however, showed to improve the appropriateness of ceftriaxone utilization.
不合理使用诸如头孢曲松等储备抗菌药物是一个全球公共卫生问题,对于像埃塞俄比亚这样的低收入国家而言尤其如此,这会导致治疗成本高昂或治疗失败。因此,本研究的目的是参照埃塞俄比亚综合医院标准治疗指南,评估亚的斯亚贝巴综合医院内科病房中头孢曲松使用的合理性。
2014年1月20日至2月20日,在哈亚特医院和泽韦迪图纪念医院的内科病房开展了一项基于机构的回顾性横断面研究。参照埃塞俄比亚综合医院标准治疗指南(2010年),对研究期间前一年入院并使用头孢曲松治疗的所有患者的用药记录进行评估。
公立和私立医院中接受头孢曲松治疗的患者比例分别为59.3%和49%。肺炎、脑膜炎和败血症是两家医院使用头孢曲松治疗的常见诊断疾病。维持液是两家医院中共同使用频率最高的药物。公立医院仅有48.9%的记录以及私立医院44.6%的记录显示头孢曲松的总体使用符合指南。住院天数与头孢曲松治疗的合理性相关。
尽管头孢曲松是两家医院最常用的药物之一,但根据埃塞俄比亚标准治疗指南,其使用的合理性低于预期。主要原因在于其适应症和治疗时长。然而,延长住院时间显示可提高头孢曲松使用的合理性。