Mabilika Richard James, Shirima Gabriel, Mpolya Emmanuel
Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and Technology, Arusha P.O. Box 447, Tanzania.
Department of Biomedical Sciences, School of Medicine and Dentistry, The University of Dodoma, Dodoma P.O. Box 395, Tanzania.
Antibiotics (Basel). 2022 Jul 31;11(8):1035. doi: 10.3390/antibiotics11081035.
Background: Accelerated by the misuse or overuse of antibiotics, antibiotic resistance remains a global public health threat. We report the prevalence and predictors of antibiotic prescriptions in primary healthcare facilities in Dodoma, Tanzania. Methods: This retrospective cross-sectional study by medical records review was conducted in the Dodoma region, Central Tanzania. Results: In this study, children < 5 years accounted for over 45% (474/1021) of the patients consulted. The majority, 76.3% (779/1021), of consultations had an antibiotic prescribed; amoxicillin and cotrimoxazole were the most prescribed. Over 98% (766/779) of the antibiotics prescribed were on the National Essential Medicines List, but only 45% (429/779) of the antibiotic prescriptions adhered to the Standard Treatment Guidelines. The prescribing of antibiotics by clinical officers was almost 2.55 times higher than that among medical doctors (Odds Ratio (OR) = 2.546; 95% Confidence Interval (CI): 1.359, 4.769; p = 0.0035). Patients with pneumonia and upper respiratory tract infection were 15.9 (OR = 15.928; 95% CI: 2.151, 17.973; p = 0.0067) and 2 (OR = 2.064; 95% CI: 1.184, 3.600; p = 0.0106) times more likely to be prescribed antibiotics, respectively. Conclusions: We, therefore, report high rates of antibiotic prescriptions, poor adherence to standard treatment guidelines and high levels of antibiotic prescribing practices among prescribers with a diploma in clinical medicine.
由于抗生素的滥用或过度使用，抗生素耐药性仍然是全球公共卫生威胁。我们报告了坦桑尼亚多多马初级卫生保健机构中抗生素处方的流行情况及预测因素。方法：通过病历回顾进行的这项回顾性横断面研究在坦桑尼亚中部的多多马地区开展。结果：在本研究中，5岁以下儿童占就诊患者的45%以上（474/1021）。大多数就诊（76.3%，779/1021）都开具了抗生素处方；阿莫西林和复方新诺明是最常开具的药物。超过98%（766/779）的抗生素处方药物在国家基本药物清单上，但只有45%（429/779）的抗生素处方符合标准治疗指南。临床医务人员开具抗生素的比例几乎是医生的2.55倍（优势比（OR）=2.546；95%置信区间（CI）：1.359，4.769；p=0.0035）。肺炎和上呼吸道感染患者开具抗生素的可能性分别高出15.9倍（OR=15.928；95%CI：2.151，17.973；p=0.0067）和2倍（OR=2.064；95%CI：1.184，3.600；p=0.0106）。结论：因此，我们报告了抗生素处方率高、对标准治疗指南的依从性差以及临床医学文凭持有者的抗生素处方行为水平高的情况。
