Antibiotics use and appropriateness in two Jordanian children hospitals: a point prevalence study. Issue 2 (23rd January 2021)

• Record Type: Journal Article
• Authors: Abdel-Qader, Derar H; Ismael, Najlaa Saadi; Albassam, Abdullah; El-Shara', Asma' A; Aljamal, Mohammed S; Ismail, Rami; Abdel-Qader, Hasan A; Hamadi, Salim; Al Mazrouei, Nadia; Ibrahim, Osama Mohamed
• Is Part Of: Journal of pharmaceutical health services research. Volume 12:Issue 2(2021)
• Page Start: 166
• Page End: 172
• Publication Date: 2021-01-23
• Subjects: Health services research -- antibiotic appopriatness -- pediatric setting -- Jordan; Pharmacy -- Research -- Periodicals; Drugs -- Research -- Periodicals; Medical care -- Research -- Periodicals; Public health -- Research -- Periodicals; Pharmaceutical industry -- Periodicals; Health Services Research -- Periodicals; Economics, Pharmaceutical -- Periodicals; 615.1072
• DOI: 10.1093/jphsr/rmaa014
• Languages: English
• ISSNs: 1759-8885

Abstract

Abstract: Background: Although inappropriate antibiotics prescribing in hospitals is a key factor in accelerating antibiotic resistance, inadequate data are available about antibiotics prescribing rate and appropriateness. Our study aimed to measure antibiotics prescribing rate, indications, appropriateness and predictors. Methods: The study was conducted in two public children hospitals (five wards) in Jordan using one-week point prevalence survey to prospectively collect the data. Appropriateness of antibiotics therapy was assessed by a multidisciplinary committee and predictors of inappropriate prescribing were studied through multivariate logistic regression. Key findings: The overall antibiotics prescribing rate was 75.6% ( n = 501/663), where the highest rate of antibiotics prescribing was in the Pediatrics ward (82.2%, n = 222/270). However, the lowest rate was in the Pediatric Intensive Care Unit (30.0%, 9/30). The most common antibiotics classes prescribed were: Beta-lactams (57.5%, n = 492/855). The most common underlying condition for antibiotics prescribing was upper respiratory tract infections (25.5%, n = 128/501) followed by pneumonia (20.6%, n = 103/501). Around half of antibiotics were prescribed upon appropriate decision (49.5%, n = 423/855). However, 22.0% ( n = 188/855) of antibiotics were wrongly chosen, and 9.5% ( n = 81/855) were wrongly applied. Initially inappropriate decision for prescription occurred in 15.3% ( n = 131/855) of antibiotics. Ceftriaxone (OR 3.1; 95% CI 2.6–4.1; P = 0.03) and patients with ≥3 medication orders (OR 2.6; 95% CI 1.7–3.5; P = 0.001) significantly predicted inappropriate antibiotics prescribing. Conclusions: The incidence of antibiotics prescribing in Jordanian children hospitals was high compared to other countries. Further multi-centric studies are required to enhance the generalisability of results and better develop effective and efficient antibiotic stewardship programmes.