Assessment of Antibiotics Prescribing Practice and Attitude towards Antibiotics Resistance of Clinicians Working in Addis Ababa Private Health Institutions

Background: Antibiotics are life savers, if properly used they are especially vital and the most commonly used drugs in developing country like my country, Ethiopia. But unfortunately these essential drugs are often misused mainly due to inappropriate prescriptions. Clinicians’ antibiotics prescribing behavior is the major contributor to antibiotics resistance.  In developing countries like ours while we focus on HIV and malnutrition, antimicrobial resistance is stabbing our Nation’s back silently.Something should be done urgently or we will not able to treat the common bacterial infections in the near future.

Methods: A cross sectional survey with internal comparison of practice of clinicians about antibiotics prescription and their attitude towards antibiotics resistance was assessed. Data was collected from 303 all level clinicians including; Specialists, residents, GPs, HOs (Health Officers), and nurses.   9 hospitals, 14 higher clinics and 17 medium clinics were randomly selected from all private health facilities found in bole sub city Addis Ababa, Ethiopia, among all the clinicians working in those selected private health facilities,  335 clinicians were selected randomly for this study. Practice and attitude questions were prepared for data collection.

Results:This study showed high rate of antibiotics prescription for viral diseases(which is inappropriate): common cold (32.2%), URTIs (82.6%), acute bronchitis (86.1%), nonspecific cough (72.8%) and watery diarrhea (77.7%).  In this study the prescription of the 3^rdgeneration cephalosporin for simple infections: Ceftriaxone , ceftazidem and vancomycine as first line treatment was also unacceptably high. This study showed nurses and HOs (OR 2.8-14) among all clinicians, those who have clinical experience less than 5 years (OR 2.3-3.4)95%CI and those who work at the medium clinics (OR 2.1-4) are more likely to prescribe antibiotics inappropriately.

Conclusion: This study has shown a very high rate of antibiotics inappropriate prescription rate.This study also showed a discrepancy between the attitude and practice of clinicians about antibiotics use and antibiotics resistance in the private health facilities. It is time for health authorities to implement urgent restrictive measures on antibiotics prescriptions to avert the rampant abuse of antibiotics.