Oli Angus Nnamdi, Onyeaso Nwanneka, Emencheta Stephen Chijioke, Ofomata Chijioke M, Kretchy James-Paul, Okhamafe Augustine, Ele Grace N
Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu, Nigeria.
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria.
J Pharm Policy Pract. 2021 Nov 30;14(1):99. doi: 10.1186/s40545-021-00380-1.
Regular evaluation of antimicrobials prescriptions is important for optimal use.
This study determined the prescription patterns, class and costs of antimicrobials in the adult out-patient pharmacy of a Teaching Hospital in Nigeria.
A 1-year retrospective study from 1st January to 31st December 2018. The data, which included identification code, age, sex, antibiotics prescribed, number of antibiotics per prescription, number of medicines per prescription, dosage form, generic prescribing, drug on the essential drug list, and cost, were used in the analysis. The Chi-square test and Analysis of Variance were used to compare our data with the WHO-developed antimicrobial prescription Guidelines for Anatomical Therapeutic Chemical and Defined Daily Dose assignment of 2019.
From 450 patient records, significantly more females (70%) were prescribed with antimicrobials (P = 0.0038). The prescription pattern showed that antimicrobials selection by class was significantly different (P < 0.0001) (top three being Amino-penicillin > Nitroimidazoles > Fluoroquinolone). In addition, age differed significantly (P < 0.0001) with 46-50 as the highest class. Dosage forms profile showed that the percentage of encounter with injections prescribed (1.8%) was less than WHO recommendation (13.4-24.1%). Most of the prescriptions (84.22%) were from the Essential Drug List. The average cost of prescriptions with two antimicrobials was the highest ($14.0807), then three ($10.7949), and one ($6.39858). The average number of drugs per prescription that had one (4.28), two (4.46), and three (5.55) antimicrobials, respectively, were more than double the average (2) recommended by WHO.
The study showed that most of the patterns are within limit, however, highlights the need for frequent evaluation.
定期评估抗菌药物处方对于优化使用至关重要。
本研究确定了尼日利亚一家教学医院成人门诊药房中抗菌药物的处方模式、类别和成本。
进行一项从2018年1月1日至12月31日的为期1年的回顾性研究。分析中使用的数据包括识别码、年龄、性别、所开抗菌药物、每张处方的抗菌药物数量、每张处方的药物数量、剂型、通用名处方、基本药物清单上的药物以及成本。使用卡方检验和方差分析将我们的数据与世界卫生组织制定的2019年解剖治疗化学分类和限定日剂量分配的抗菌药物处方指南进行比较。
从450份患者记录来看，使用抗菌药物的女性明显更多（70%）（P = 0.0038）。处方模式显示，按类别选择抗菌药物存在显著差异（P < 0.0001）（前三位是氨基青霉素>硝基咪唑类>氟喹诺酮类）。此外，年龄差异显著（P < 0.0001），46 - 50岁年龄段为最高类别。剂型情况表明，注射剂处方的占比（1.8%）低于世界卫生组织的建议（13.4 - 24.1%）。大多数处方（84.22%）来自基本药物清单。含两种抗菌药物的处方平均成本最高（14.0807美元），其次是含三种抗菌药物的处方（10.7949美元）和含一种抗菌药物的处方（6.39858美元）。每张分别含有一种（4.28种）、两种（4.46种）和三种（5.55种）抗菌药物的处方的平均药物数量是世界卫生组织建议的平均数量（2种）的两倍多。
该研究表明大多数模式在合理范围内，然而，突出了频繁评估的必要性。
