Alshaikh Adel Ahmed, Kubas Mohammed Abdullah
Department of Clinical Pharmacy and Medical Sciences, Lebanese International University, Sana'a, Yemen.
Department of Clinical Pharmacy & Pharmacy Practice, University of Science and Technology, Sana'a, Yemen.
PLoS One. 2025 Aug 22;20(8):e0330714. doi: 10.1371/journal.pone.0330714. eCollection 2025.
Antibiotics (ABs) have saved countless lives, but their misuse has led to a serious problem: antibiotic resistance. This growing phenomenon poses serious threats to public health worldwide, as it could make treating infections significantly more difficult in the future.
This study aimed to investigate antibiotic consumption and use patterns in a tertiary hospital in Sana'a, Yemen, by comparing Prescribed Daily Doses (PDD) to Defined Daily Doses (DDD), and identifying factors associated with antibiotic misuse and its impact on patient outcomes.
A prospective cross-sectional study was conducted among adult inpatients in a tertiary hospital in Sana'a, Yemen over two months (January 12 to March 11, 2024), involving 597 patients. Data on antibiotic prescriptions, patient demographics, and outcomes were collected.
A high prevalence of antibiotic use was observed (92.5%), with a notable proportion of prescriptions from the "Watch" category (56.7%). Significant PDD-DDD deviations were common, encompassing both overuse (36.8%) and underuse (63.2%). Factors associated with antibiotic deviations included patient age (26-44 years), gender (female), and ward type (private). The most commonly prescribed antibiotics were Ceftriaxone (33.6%), Metronidazole (21.8%), Vancomycin (6.0%), Levofloxacin (4.9%), Imipenem/Cilastatin (4.7%), and Moxifloxacin (3.6%). Notable deviations from DDD were observed for Levofloxacin (overuse by 28%), Imipenem/Cilastatin (underuse by 40.5%), and other agents. Antibiotic misuse was associated with longer hospital stays and less favorable discharge outcomes.
The study found an alarmingly high prevalence of antibiotic use and excessive consumption, with both overuse and underuse patterns observed, underscoring the need for effective regulatory interventions and improved antibiotic stewardship in Yemen.
抗生素挽救了无数生命，但其滥用导致了一个严重问题：抗生素耐药性。这一日益严重的现象对全球公共卫生构成严重威胁，因为未来可能会使感染治疗变得更加困难。
本研究旨在通过比较规定日剂量（PDD）与限定日剂量（DDD），调查也门萨那一家三级医院的抗生素消费及使用模式，并确定与抗生素滥用相关的因素及其对患者结局的影响。
对也门萨那一家三级医院的成年住院患者进行了为期两个月（2024年1月12日至3月11日）的前瞻性横断面研究，涉及597名患者。收集了抗生素处方、患者人口统计学资料及结局数据。
观察到抗生素使用的高患病率（92.5%），其中“观察”类别的处方比例显著（56.7%）。PDD与DDD之间的显著偏差很常见，包括过度使用（36.8%）和使用不足（63.2%）。与抗生素偏差相关的因素包括患者年龄（26 - 44岁）、性别（女性）和病房类型（私立）。最常开具的抗生素为头孢曲松（33.6%）、甲硝唑（21.8%）、万古霉素（6.0%）、左氧氟沙星（4.9%）、亚胺培南/西司他丁（4.7%）和莫西沙星（3.6%）。左氧氟沙星（过度使用28%）、亚胺培南/西司他丁（使用不足40.5%）及其他药物与DDD存在显著偏差。抗生素滥用与住院时间延长及出院结局较差有关。
该研究发现抗生素使用和过度消费的患病率高得惊人，同时存在过度使用和使用不足的模式，这突出表明也门需要有效的监管干预措施并改善抗生素管理。
