International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 1, pp: (86-90), Month: April 2020 - September 2020, Available at: www.researchpublish.com
Anti-microbial utilization in teaching hospitals of Kabul University of Medical Sciences Ershad Ahmad Mushkani1, Fahima Hamidy2 1
Assistant Professor, Department of Pharmacology, Kabul University of Medical Sciences.
2
Assistant Professor, Department of Clinical Nursing, Kabul University of Medical Sciences. Kabul University of Medical Sciences, Kabul, Afghanistan
Abstract: Antimicrobial resistance is a globally major concern. In developing countries like Afghanistan overuse, misuse, low-quality medicine, self-medication, and irrational use of anti-infection agents are common which may cause antimicrobial resistance. To have Information about anti-infectives prescribing patterns in medical clinics is significant in improving the nature of antimicrobial prescriptions. This cross-sectional study was conducted on the use of antimicrobial agents in teaching hospitals of Kabul University of Medical Sciences which is a tertiary care hospital in Kabul, Afghanistan. Data were collected from the medical records department, all in-patients which they admitted during two months from January-February were included. In our study, we found that 519 (85.5%) of 607 patients who were admitted to the hospital received at least one anti-infectives. The average number of antiinfectives per hospitalization was 1.4. Cephalosporins were found to be the majority being 61.3% of the total antiinfectives prescribed, this was followed by Nitroimidazole (15.7%), Fluoroquinolones (9.7%), Penicillins (7.2%), and Aminoglycosides (1.8%). Antimicrobials were ordered empirically in 99% of patients. The percentage of generic prescriptions was 99%. The most antimicrobial prescription was empirically and overuse of ceftriaxone among of anti-infectives medicines is a major concern therefore, educational program regarding antimicrobial resistance is necessary for physicians. Keywords: Anti-microbial, utilization, Kabul, teaching hospitals.
I. INTRODUCTION Anti-infective medicines have diminished the burden of common infectious illnesses and their utilization has become crucial for many medical interventions.1,2 There usages are often empiric and based on physician comfort and prior experience, often leading to overuse or misuse of anti-infectives, This expands treatment costs, leads patients to the side effects of these medications as well as increase antimicrobial resistance.3,4 Over the previous decade it has been seen that anti-infectives use is on the ascent globally this may cause antimicrobial resistance.5,6,7 Antimicrobial resistance is a globally major concern in developing countries like Afghanistan, low-quality medicine, together with self-medication and misuse use are major contributing factors.8 Irrational, overuse and abuse of anti-infection agents are common in different counties, a study in New Delhi clearly shows overuse and inappropriate choice of antimicrobial for the treatment of acute, uncomplicated respiratory tactic infections which are mainly due to virus and do not require anti-infective treatment.9 A study in Iran shows a high rate of empirical and prophylactic antibiotics use, overuse of vancomycin and third-generation cephalosporin.10 There is limited data on anti-infective prescription, consumption patterns, especially at admission patients in public hospitals in Kabul. The objective of this study is to evaluate the rational use of anti-infectives medicines in public hospitals of Kabul, by the using WHO drug use indicator.
II. METHODS The study is a cross-sectional descriptive which was done in ten selected wards (Surgery, Orthopaedics, ENT, Ophthalmology, Medicine, Neurosurgery, Obstetrics/Gynaecology, Urology, Dermatology, and Paediatrics) of teaching
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