An evaluation of antimicrobial medicines prescribing practices in Yumbe district, Uganda.

Abstract

The irrational use of Antimicrobial medicines from health facilities decreases their usefulness due to the emergence of resistant strains of microorganisms and hence; an area of high concern for health personnel in improving patient outcomes and welfare. The irrational prescription of antimicrobials is the main modifiable driver of antimicrobial resistance. Ensuring access to effective antimicrobials and rational prescribing of antimicrobials is critical in reducing antimicrobial resistance and therefore prolonging their efficacy. In this study we evaluated antimicrobials prescription practices in Yumbe District. To accomplish this, a cross sectional study design was employed to evaluate prescribing practices of antimicrobial medicines for a period of three months in five health facilities. World Health Organization (WHO) – core drug indicators were used. The study was conducted with a sample of 500 prescriptions, 100 from each facility were reviewed. Prescriptions were systematically sampled. The data was analyzed using Microsoft Excel 2010. Percentage of encounters with one or more antimicrobial medicines prescribed in the review period 23%. The majority of the prescriptions (66%) were not in compliance with the national treatment guideline, prescription encounters 23%, mean number of antimicrobial medicines per prescription from the five health centers was 1.338 with 55.2% prescribed generically and 100% from the EMHSL. An injection was found among 18.7% of the prescriptions. Antimicrobial medicine prescribed for diagnosis as per standard treatment guideline was 48%. The average cost per prescription was Uganda shillings 1,795 ($0.5). Unnecessary antimicrobial medicines use is still common in real-world clinical practice and remains a public health challenge. This study shows that routine assessment of prescribing practices is useful to evaluate antimicrobial prescribing patterns, to identify possible irrational use of antimicrobial medicines, provide feedback and to improve the quality of antimicrobial medicines use. The government should continue to strengthen the administration of antimicrobials use in health facilities and hospitals through medical professional training and interventions to enforce the national standard treatment guidelines and thus reducing the irrational prescribing practices of antimicrobial medicines