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PRESCRIPTION DAYS OFFERED FOR CHILDHOOD INFECTIONS BY RESIDENTS AND PEDIATRICIANS IN ETHIOPIA VARY FROM INTERNATIONALLY RECOGNIZED GUIDELINES: INDIFFERENCE PROMOTES SUB-OPTIMAL PATIENT OUTCOMES AND ANTIMICROBIAL RESISTANCE
Abstract
Background
Unregulated antimicrobial use, lack of clinical microbiology laboratories and trained personnel are driving antimicrobial resistance in developing countries. .
Aims
The objective of the study was to compare antimicrobial prescription days recommended by pediatric residents and pediatricians in Addis Ababa, Ethiopia with guidelines published by internationally recognized bodies.
Methods
This descriptive cross-sectional study was conducted from February - July, 2020. Data on recommendations on length of antimicrobial prescription were collected from pediatricians and pediatric residents in Addis Ababa, Ethiopia. Responses were summarized using descriptive quantitative analysis and their conformity to recommendations of internationally recognized guidelines was evaluated. Differences between sub-groups was determined by the Mann-Whitney U test. Analyses were done using Statistical package for the social sciences (SPSS) version 20.0 and significant differences ascertained at p-value < 0.05.
Results
A total of 88 respondents participated in the stud. Many respondents suggested prescription days exceeding recommendations for common pediatric infections; notably for conjunctivitis, cystitis, cellulitis and lower respiratory infections. Antimicrobial durations often came short of standard recommendations for tonsillopharyngitis, amebiasis and pyomyositis. Pediatricians favored less prescription days for endocarditis, hospital acquired pneumonia, cystitis and conjunctivitis. Inter-group differences were significant when prescribing for meningococcal meningitis, otitis media, Candida central line infections and non-gonococcal septic arthritis. Overall, respondents suggested 11,828.6 prescription days exceeding guideline recommendations.
Conclusions
Prescription days offered by pediatric residents and pediatricians practicing in Addis Ababa, Ethiopia differed from those recommended by guidelines for most childhood infections. Observance of evidence-based antimicrobial guidelines leads to favorable patient outcomes, fewer drug-related toxicities and prevention of antimicrobial resistance.