Antibiotic prescription audit at University Teaching Hospitals in Rwanda

Abstract

Abstract Background: Antibiotic resistance is becoming a public health threat worldwide. This assessment of antibiotic prescription in Teaching Hospitals in Rwanda (Centre Hospitalier Universitaire de Kigali (CHUK) and Centre Hospitalier Universitaire de Butare (CHUB) describes the antibiotic prescription patterns, the compliance to the standards treatment guidelines (STGs) while prescribing antibiotics, and describes the awareness of the prescribers of the STGs. Methods: Data were collected in patients' files for those admitted to Clinical Departments from July to December 2019. Only patients who received antibiotics were selected. With a questionnaire, we collected data on the rate of use of standards treatment guidelines while prescribing antibiotics and the degree of satisfaction of medical doctors with the functionality of the Drug and Therapeutic Committees (DTC). Questionnaires have been filled by medical doctors. The research has been conducted from May 2020 to August 2021. Results: The assessment of quality indicators of prescription of antibiotics shows gaps in antibiotics prescriptions. Prescriptions were not fully completed and the end date and route of administration were less recorded (27.7% and 79.8% respectively). Antibiotics prescribed were at 99.4% in-hospital drug formulary lists and were prescribed by generic names at 84.8%. Potential drug-drug interactions were observed at a rate of 47.46% with the antibiotics prescribed to the patient for which 9.69% were major, 10.17% minor, and 27.6% moderate. Conclusion and recommendations: Antibiotic prescription in teaching hospitals in Rwanda needs to make adequate interventions to improve the clinical use of antibiotics. Prescribers should prescribe according to STGs with all relevant information as required. Uniform treatment sheets should be developed in CHUB to avoid medication errors. Monitoring of the use of antibiotics should be done to reduce the use of non-indicated antibiotics, duplicated antibiotics, and antibiotics with potential interactions which may lead to an increase in antibiotic resistance, increase the risk of harm to patients and increase healthcare costs. There is a need for hospitals to hire clinical pharmacists to deal with the rational use of medications. DTCs in teaching hospitals need to improve their functionality and put in place antibiotic stewardship programs to address deficiencies in antibiotic rational use.