Adi-Tekelezan Community Hospital, Ministry of Health, Adi-Tekelezan, Anseba Region, Eritrea
Product Evaluation and Registration, National Medicine and Food Administration, Asmara, Eritrea.
BMJ Open. 2024 Jun 3;14(6):e085743. doi: 10.1136/bmjopen-2024-085743.
To assess antibiotic prescribing practice and its determinants among outpatient prescriptions dispensed to the elderly population.
A prescription-based, cross-sectional study.
Six community chain pharmacies in Asmara, Eritrea.
All outpatient prescriptions dispensed to the elderly population (aged 65 and above) in the six community chain pharmacies in Asmara, Eritrea.
Data were collected retrospectively, between 16 June 2023 and 16 July 2023. Antibiotic prescribing practice was assessed using the 2023 World Health Organization (WHO) Access, Watch and Reserve (AWaRe) classification system. Descriptive statistics and logistic regression were performed using IBM SPSS (V.26.0). P values less than 0.05 were considered as significant.
Of the 2680 outpatient prescriptions dispensed to elderly population, 35.8% (95% CI: 34.0, 37.6) contained at least one antibiotic. Moreover, a total of 1061 antibiotics were prescribed to the elderly population. The most commonly prescribed antibiotics were ciprofloxacin (n=322, 30.3%) and amoxicillin/clavulanic acid (n=145, 13.7%). The Access category accounted for the majority of antibiotics (53.7%) with 32.1% from the Watch category. Prescriber qualification (Adjusted Odds Ratio (AOR)= 0.60, 95% CI: 0.44, 0.81) and polypharmacy (AOR= 2.32, 95% CI: 1.26, 4.27) were significant determinants of antibiotic prescribing in the elderly population. Besides, sex (AOR=0.74, 95% CI: 0.56, 0.98), prescriber qualification (AOR=0.49, 95% CI: 0.30 to0.81) and level of health facility (AOR 0.52, 95% CI 0.34 to 0.81) were significant determinants of a Watch antibiotic prescription.
Antibiotics were prescribed to a considerable number of the elderly population, with more than half of them falling into the Access category. Further efforts by policy-makers are needed to promote the use of Access antibiotics while reducing the use of Watch antibiotics to mitigate risks associated with antimicrobial resistance.
评估向老年人群开出的门诊处方中抗生素的使用情况及其决定因素。
基于处方的横断面研究。
厄立特里亚阿斯马拉的六家社区连锁药店。
在厄立特里亚阿斯马拉的六家社区连锁药店开出的所有老年（65 岁及以上）门诊处方。
数据于 2023 年 6 月 16 日至 7 月 16 日期间进行回顾性收集。使用 2023 年世界卫生组织（WHO）准入、监控和储备（AWaRe）分类系统评估抗生素使用情况。采用 IBM SPSS（V.26.0）进行描述性统计和逻辑回归。P 值小于 0.05 被认为具有统计学意义。
在向老年人群开出的 2680 张门诊处方中，有 35.8%（95%CI：34.0，37.6）至少含有一种抗生素。此外，共有 1061 种抗生素被开给了老年人群。最常开的抗生素是环丙沙星（n=322，30.3%）和阿莫西林/克拉维酸（n=145，13.7%）。准入类抗生素占大多数（53.7%），监控类抗生素占 32.1%。医生资质（调整后的优势比（AOR）=0.60，95%CI：0.44，0.81）和多药治疗（AOR=2.32，95%CI：1.26，4.27）是老年人群抗生素使用的显著决定因素。此外，性别（AOR=0.74，95%CI：0.56，0.98）、医生资质（AOR=0.49，95%CI：0.30 至 0.81）和医疗机构级别（AOR 0.52，95%CI 0.34 至 0.81）是开出监控类抗生素处方的显著决定因素。
相当数量的老年人群被开出了抗生素，其中一半以上属于准入类。决策者需要进一步努力，促进使用准入类抗生素，同时减少监控类抗生素的使用，以减轻与抗菌药物耐药性相关的风险。
