The Need for Antimicrobial Stewardship: Prospective Study on Antimicrobial Utilization Pattern at Gondar Referral Hospital, North West Ethiopia

Aims: The aim of the present study was to assess antimicrobials utilization pattern among patients admitted in internal medicine wards.
Setting: The study was conducted at Gondar University Hospital, Northwest Ethiopia.
Methods: Prospective follow-up study design was used to assess antimicrobial utilization pattern of patients in internal medicine wards. Patients admitted in four internal medicine wards were followed prospectively over a month and a half.
Main Outcome Measures: WHO/INRUD hospital and patient care indicators for the use of antimicrobials were utilized to measure rational drug use. Descriptive and analytical statistics were done using SPSS version 19.
Results: A total of 142 patients were admitted in four wards during the study period. Of these, 85(59.8%) were initiated on one or more antimicrobials in their treatment regimen. Over the course of the study, a total of 238 patient antimicrobials were prescribed, of which 42% were intravenous. Average number of antimicrobials per hospitalization was found to be 2.8±1.4. Pneumonia was the most frequent diagnosis and Cephalosporin, notably Ceftriaxone was the most frequently prescribed medication. From total diagnoses undertaken, 45.8% were treated in-line with the national standard treatment guideline. Median duration of total antimicrobial course was 13 days, while the average hospital stays of patients were 17 days.
Conclusion: Higher consumption of antimicrobials and conspicuously broad-spectrum antibiotics was observed during the study period. Most of the antimicrobials were prescribed empirically rather than waiting laboratory diagnosis for definitive therapy. Utilization pattern of antimicrobials was, mostly not in concordance with the national standard treatment guideline. Hence, there is a need for further large scale study on the utilization pattern of antimicrobials nationwide and antimicrobial stewardship in Gondar University Hospital.