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Assessment of the appropriateness of antibiotic prescriptions in Lesotho public hospitals: a novel methodology based on principles of antibiotic prescribing

Matthias Adorka, Honoré Kabwebwe Mitonga, Martie Lubbe, Jan Serfontein, Kirk Allen
  • Matthias Adorka
    School of Pharmacy, University of Namibia, Windhoek, Namibia | madorka@yahoo.com
  • Honoré Kabwebwe Mitonga
    Department of Community Medicine, University of Namibia, Windhoek, Namibia
  • Martie Lubbe
    Medicine Usage in South Africa, School of Pharmacy, North-West University, Potchefstroom, South Africa
  • Jan Serfontein
    Medicine Usage in South Africa, School of Pharmacy, North-West University, Potchefstroom, South Africa
  • Kirk Allen
    Medical and Pharmaceutical Biotechnology Unit, Research Center in Technology and Design Assistance of Jalisco State (CIATEJ), Guadalajara, Mexico

Abstract

The study primarily aimed at assessing the appropriateness of antibiotic prescriptions in a section of public health institutions in Lesotho using an assessment tool formulated from principles of antibiotic prescribing. Relevant data on procedures of infection diagnosis and prescribed antibiotics were collected from both inpatient and outpatient case reports for a onemonth period in five public hospitals in Lesotho. These were analyzed for the appropriateness of the prescribed antibiotics. Prescription appropriateness assessment was based on conformities of prescribed antibiotics to criteria developed from pertinent principles of antibiotic prescribing. Assessed prescriptions, 307 inpatient and 865 outpatient prescriptions in total, were classified into categories of appropriateness based on extents to which they satisfied conditions defined by combinations of criteria in the assessment tool. Antibiotic prescriptions from inpatient and outpatient departments of study site hospitals were categorized into groups of different degrees of appropriateness. A total of 32.2% inpatient prescriptions and 78.4% outpatient prescriptions assessed were appropriately written for the empiric treatment of infections for which bacterial pathogens were considered absolute or possible etiologies. The use of prescription assessment tools based on principles of antibiotic prescribing is a feasible option of assessing the appropriateness of antibiotic prescriptions, particularly in low-income countries where expert panels cannot be formed.

Keywords

antibiotic prescriptions, appropriateness, alternative method, bacterial etiologies, Lesotho.

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Submitted: 2013-06-28 12:49:55
Published: 2014-05-13 12:44:09
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Copyright (c) 2014 Matthias Adorka, Honoré Kabwebwe Mitonga, Martie Lubbe, Jan Serfontein, Kirk Allen

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