Inappropriate ceftriaxone utilization and predictor factors in Ethiopia: a systematic review and meta-analysis.
Ceftriaxone
Ethiopia
Inappropriate utilization
Meta-analysis
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
23 10 2024
23 10 2024
Historique:
received:
25
04
2024
accepted:
08
10
2024
medline:
24
10
2024
pubmed:
24
10
2024
entrez:
24
10
2024
Statut:
epublish
Résumé
Ceftriaxone stands as a cornerstone in global antibiotic therapy owing to its potent antibacterial activity, broad spectrum coverage, and low toxicity. Nevertheless, its efficacy is impeded by widespread inappropriate prescribing and utilization practices, significantly contributing to bacterial resistance. The aim of this study is to determine the overall national pooled prevalence of inappropriate ceftriaxone utilization and its predictor factors in Ethiopia. A systematic search was conducted across multiple databases including, PubMed, Science Direct, Hinari, Global Index Medicus, Scopus, Embase, and a search engine, Google Scholar, to identify relevant literatures that meet the research question, from March 20 to 30, 2024. This meta-analysis, which was conducted in Ethiopia by incorporating 17 full-text articles, unveiled a national pooled inappropriate ceftriaxone utilization of 55.24% (95% CI, 42.17%, 68.30%) with a substantial heterogeneity index (I2 = 99.24%, p value < 0.001). The review has also identified predictive factors for the inappropriate use of ceftriaxone: empiric therapy (AOR 21.43, 95% CI; 9.26-49.59); multiple medication co-prescription (AOR: 4.12, 95% CI; 1.62-8.05). Emergency ward (AOR: 4.22, 95% CI; 1.8-12.24), surgery ward (AOR: 2.6, 95% CI; 1.44-7.82) compared to medical ward, prophylactic use (AOR: 500, 95% CI; 41.7-1000), longer hospital stay-8-14 Days; (AOR: 0.167, 95% CI; 0.09-0.29), > 14 days; (AOR: 0.18, 95% CI; 0.1-0.32). The study reveals a high national pooled prevalence of inappropriate ceftriaxone utilization, standing at 55.24%, highlighting a significant hazard in the use of this antibiotic. This could be attributed to instances of overuse, misuse or prescription practices that deviates from established guidelines. This eminent challenge can lead to the development of antibiotic resistance, increased healthcare costs, adverse drug reactions, and treatment failures, necessitating multifaceted approach such as improved antibiotic stewardship, better adherence to guidelines, and enhanced clinician education on appropriate antibiotic use.
Identifiants
pubmed: 39443593
doi: 10.1038/s41598-024-75728-z
pii: 10.1038/s41598-024-75728-z
doi:
Substances chimiques
Ceftriaxone
75J73V1629
Anti-Bacterial Agents
0
Types de publication
Journal Article
Systematic Review
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
25035Informations de copyright
© 2024. The Author(s).
Références
Tassew, S. G., Abraha, H. N., Gidey, K. & Gebre, A. K. Assessment of drug use pattern using WHO core drug use indicators in selected general hospitals: A cross-sectional study in Tigray region, Ethiopia. BMJ Open 11(10), e045805 (2021).
pubmed: 34706944
pmcid: 8552154
doi: 10.1136/bmjopen-2020-045805
WHO. Rational use of medicines by prescribers and patients. Report by the secretariat. 16 (2004).
Wendie, T. F., Ahmed, A. & Mohammed, S. A. Drug use pattern using WHO core drug use indicators in public health centers of Dessie, North-East Ethiopia. BMC Med. Inf. Decis. Mak. 21(1), 197 (2021).
doi: 10.1186/s12911-021-01530-w
Mamo, D. B. & Alemu, B. K. Rational drug-use evaluation based on World Health Organization core drug-use indicators in a tertiary referral hospital, Northeast Ethiopia: A cross-sectional Study. Drug Healthc. Patient Saf. 15–21. (2020).
WHO. The Pursuit of Responsible Use of Medicines: Sharing and Learning from Country Experiences (World Health Organization, 2012).
Soman, N., Panda, B. K., Banerjee, J. & John, S. M. A study on prescribing pattern of cephalosporins utilization and its compliance towards the hospital antibiotic policy in surgery ward of a tertiary care teaching hospital in India. Int. Surg. J. 6(10), 3614–3621 (2019).
doi: 10.18203/2349-2902.isj20194413
Girma, S., Sisay, M., Mengistu, G., Amare, F. & Edessa, D. Antimicrobial utilization pattern in pediatric patients in tertiary care hospital, Eastern Ethiopia: The need for antimicrobial stewardship. Hosp. Pharm. 53(1), 44–54 (2018).
pubmed: 29434387
doi: 10.1177/0018578717737429
Sileshi, A., Tenna, A., Feyissa, M. & Shibeshi. W. Evaluation of ceftriaxone utilization in medical and emergency wards of Tikur Anbessa specialized hospital: A prospective cross-sectional study (2016).
Sasi, P., Mwakyandile, T., Manyahi, J., Kunambi, P., Mugusi, S. & Rimoy, G. Ceftriaxone prescribing and resistance pattern at a national hospital in Tanzania (2020).
Menkem, E. Z., Labo Nanfah, A., Takang, T., Ryan Awah, L., Awah Achua, K., Ekane Akume, S. et al. Attitudes and practices of the use of third-generation cephalosporins among medical doctors practicing in Cameroon. Int. J. Clin. Pract. 2023 (2023).
WHO. Promoting Rational Use of Medicines: Core Components (World Health Organization, 2002).
Rehman, M. J. S., Alrowaili, M., Rauf, A. W. A. & Eltom, E. H. Ceftriaxone drug utilization evaluation (DUE) at Prince Abdulaziz Bin Moussae’ed Hospital, Arar, Kingdom of Saudi Arabia. Sudan J. Med. Sci. 14(4), 266–275 (2019).
Lee, H. et al. Evaluation of ceftriaxone utilization at multicenter study. Korean J. Int. Med. 24(4), 374 (2009).
doi: 10.3904/kjim.2009.24.4.374
Page, M. J. et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 372, n71 (2021).
pubmed: 33782057
pmcid: 8005924
doi: 10.1136/bmj.n71
Borenstein, M., Hedges, L. V., Higgins, J. P. & Rothstein, H. R. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res. Synth. Methods 1(2), 97–111 (2010).
pubmed: 26061376
doi: 10.1002/jrsm.12
Rücker, G., Schwarzer, G., Carpenter, J. R. & Schumacher, M. Undue reliance on I 2 in assessing heterogeneity may mislead. BMC Med. Res. Methodol. 8, 1–9 (2008).
doi: 10.1186/1471-2288-8-79
Higgins, J. P. & Green, S. Cochrane handbook for systematic reviews of interventions (2008).
Lin, L. et al. Empirical comparison of publication bias tests in meta-analysis. J. General Int. Med. 33, 1260–1267 (2018).
doi: 10.1007/s11606-018-4425-7
Wells, G. A., Shea, B., O’Connell, D., Peterson, J., Welch, V., Losos, M. et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses (2000).
Qumseya, B. J. Quality assessment for systematic reviews and meta-analyses of cohort studies. Gastrointest. Endosc. 93(2), 486–94 (2021).
pubmed: 33068610
doi: 10.1016/j.gie.2020.10.007
FMHACA. Standard Treatment Guidelines for General Hospital. FMHACA Addis Ababa, Ethiopia (2014).
Gelaw, L. Y., Bitew, A. A., Gashey, E. M. & Ademe, M. N. Ceftriaxone resistance among patients at GAMBY teaching general hospital. Sci. Rep. 12(1) (2022).
Drug use evaluation of ceftriaxone at Adama Hospital Medical College medical WARD, Adama, Ethiopia 2015 [Internet]. 2015 [cited 4/15/2024]. Available from: https://www.coursehero.com/file/220942727/ceftriaxonedocx/ .
Garedow, A. W. & Tesfaye, G. T. Evaluation of antibiotics use and its predictors at pediatrics ward of Jimma Medical Center: Hospital based prospective cross-sectional study. Infect. Drug Resist. 15, 5365–5375 (2022).
pubmed: 36110127
pmcid: 9469905
doi: 10.2147/IDR.S381999
Mama, M. et al. Inappropriate antibiotic use among inpatients attending Madda Walabu University Goba Referral Hospital, Southeast Ethiopia: Implication for future use. Infect. Drug Resist. 13, 1403–1409 (2020).
pubmed: 32494171
pmcid: 7229800
doi: 10.2147/IDR.S251151
Abebe, F. A., Berhe, D. F., Berhe, A. H., Hishe, H. Z. & Akaleweld, M. A. Drug use evaluation of ceftriaxone: The case of Ayder Referral Hospital, Mekelle, Ethiopia. Int. J. Pharm. Sci. Res. 3(7), 2191 (2012).
Amare, F., Gashaw, T., Sisay, M., Baye, Y. & Tesfa, T. The appropriateness of ceftriaxone utilization in government hospitals of Eastern Ethiopia: A retrospective evaluation of clinical practice. SAGE Open Med. 9, 20503121211051524 (2021).
pubmed: 34691471
pmcid: 8532238
doi: 10.1177/20503121211051525
Ayele, A. A., Gebresillassie, B. M., Erku, D. A., Gebreyohannes, E. A., Demssie, D. G., Mersha, A. G. et al. Prospective evaluation of Ceftriaxone use in medical and emergency wards of Gondar university referral hospital, Ethiopia. Pharmacol. Res. Perspect. 6(1) (2018).
Ayinalem, G. A., Gelaw, B. K., Belay, A. Z. & Linjesa, J. L. Drug use evaluation of ceftriaxone in medical ward of Dessie Referral Hospital, North East Ethiopia. Int. J. Basic Clin. Pharmacol. 2(6), 711–717 (2013).
doi: 10.5455/2319-2003.ijbcp20131208
Bantie, L. Drug use evaluation (DUE) of Ceftriaxone injection in the in-patient wards of Felege Hiwot Referral Hospital (FHRH), Bahir Dar, North Ethiopia. Int. J. Pharm. Sci. 4, 671–676 (2014).
Geresu, G., Yadesa, T. & Deresa, B. Drug use evaluation of ceftriaxone in medical ward of Mizan Aman general hospital, Bench Maji Zone, South Western Ethiopia. J. Bioanal. Biomed. 10, 127–131 (2018).
doi: 10.4172/1948-593X.1000221
Hafte, K., Tefera, K., Azeb, W., Yemsrach, W. & Ayda, R. Assessment of ceftriaxone use in Eastern Ethiopian Referral Hospital: A retrospective study. J. Infect. Dis. Med. Microbiol. 2, 26–29 (2018).
Mehari, K. Evaluation of Ceftriaxone Utilization and Prescriber’s Opinion at Armed Forces Referral and Teaching Hospital, Addis Ababa (Addis Ababa University, 2017).
Muhammed, O. S. & Nasir, B. B. Drug use evaluation of ceftriaxone in Ras-Desta Memorial General Hospital, Ethiopia. Drug Healthc. Patient Saf 12, 161–168 (2020).
pubmed: 32982467
pmcid: 7490085
doi: 10.2147/DHPS.S260364
Sewagegn, N. et al. Evaluation of ceftriaxone use for hospitalized patients in Ethiopia: The case of a referral hospital. Int. J. Pharm. Sci. Sci. Res. 3, 26–31 (2017).
Shegute, T., Hiruy, M., Hadush, H. & Gebremeskel, L. Ceftriaxone use evaluation in Western Zone Tigray Hospitals, Ethiopia: A retrospective cross-sectional study. BioMed. Res. Int. 2023 (2023).
Shimels, T., Bilal, A. I. & Mulugeta, A. Evaluation of ceftriaxone utilization in internal medicine wards of general hospitals in Addis Ababa, Ethiopia: A comparative retrospective study. J. Pharm. Policy Pract. 8(26), 26 (2015).
pubmed: 26557367
pmcid: 4638109
doi: 10.1186/s40545-015-0047-1
Shimels, T. & Fenta, T. G. Assessment of ceftriaxone utilization in different wards of the federal police referral hospital in Ethiopia: A retrospective study. Ethiop. Pharm. J. 31(2), 141–150 (2015).
doi: 10.4314/epj.v31i2.6
Taressa, D., Sosengo, T., Abera Jambo, E. M., Abdella, J. & Amare, F. Appropriateness of ceftriaxone prescription: A case of Haramaya hospital Eastern Ethiopia. J. Basic Clin. Pharm. 12(3), 7 (2021).
Werede, A. et al. Drug use evaluation study of ceftriaxone in Ras Desta Damtew Memorial Hospital 2022 GC. Biomed. J. Sci Tech. Res. Soc. Dev. 50(1), 41221–6 (2023).
Jifar, W. W., Adugna, D., Gadisa, B., Debele, G. R. & Admasu, T. T. Retrospective drug use evaluation of ceftriaxone in resource limited setting in case of Bedele General Hospital, Ethiopia. pp 1–14 (2022).
Chang, Y. et al. The 5 min meta-analysis: Understanding how to read and interpret a forest plot. Eye 36(4), 673–675 (2022).
pubmed: 34987196
pmcid: 8956732
doi: 10.1038/s41433-021-01867-6
Deeks, J. J., Higgins, J. P., Altman, D. G. & Group, C. S. M. Analysing data and undertaking meta‐analyses. Cochrane handbook for systematic reviews of interventions. pp 241–84 (2019).
Bown, M. J. & Sutton, A. J. Quality control in systematic reviews and meta-analyses. Eur. J. Vasc. Endovasc. Surg. 40(5), 669–677 (2010).
pubmed: 20732826
doi: 10.1016/j.ejvs.2010.07.011
Kutyabami, P. et al. Evaluation of the clinical use of ceftriaxone among in-patients in selected health facilities in Uganda. Antibiotics 10(7), 779 (2021).
pubmed: 34202391
pmcid: 8300672
doi: 10.3390/antibiotics10070779
Berhe, Y. H., Amaha, N. D. & Ghebrenegus, A. S. Evaluation of ceftriaxone use in the medical ward of Halibet National Referral and teaching hospital in 2017 in Asmara, Eritrea: A cross sectional retrospective study. BMC Infect. Dis. 19, 1–7 (2019).
doi: 10.1186/s12879-019-4087-z
Davey P, Brown E, Charani E, Fenelon L, Gould IM, Holmes A, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane database of systematic reviews. 2013(4).
Cella, E. et al. Joining forces against antibiotic resistance: The one health solution. Pathogens 12(9), 1074 (2023).
pubmed: 37764882
pmcid: 10535744
doi: 10.3390/pathogens12091074
Salam, A., Al-Amin, Y., Salam, M. T., Pawar, J. S., Akhter, N., Rabaan, A. A. et al. editors. Antimicrobial resistance: A growing serious threat for global public health. Healthcare MDPI (2023).
Durham, S. H., Wingler, M. J. & Eiland, L. S. Appropriate use of ceftriaxone in the emergency department of a Veteran’s health care system. J. Pharm. Technol. 33(6), 215–218 (2017).
pmcid: 5998470
doi: 10.1177/8755122517720293
Malik, M. et al. Evaluation of the appropriate use of ceftriaxone in internal medicine wards of Wad Medani Teaching Hospital in Sudan. Int. J. Med. Sci. Clin. Invent. 7, 4757–4765 (2020).
Gorgulho, A. et al. Appropriateness of empirical prescriptions of ceftriaxone and identification of opportunities for stewardship interventions: A single-centre cross-sectional study. Antibiotics 12(2), 288 (2023).
pubmed: 36830199
pmcid: 9952766
doi: 10.3390/antibiotics12020288
McGregor, J. C. et al. A systematic review of the methods used to assess the association between appropriate antibiotic therapy and mortality in bacteremic patients. Clin. Infect. Dis. 45(3), 329–337 (2007).
pubmed: 17599310
doi: 10.1086/519283
Laxminarayan, R. et al. Antibiotic resistance—the need for global solutions. Lancet Infect. Dis. 13(12), 1057–1098 (2013).
pubmed: 24252483
doi: 10.1016/S1473-3099(13)70318-9
Ayukekbong, J. A., Ntemgwa, M. & Atabe, A. N. The threat of antimicrobial resistance in developing countries: Causes and control strategies. Antimicrob. Resist. Infect. Control 6(1), 47 (2017).
pubmed: 28515903
pmcid: 5433038
doi: 10.1186/s13756-017-0208-x
Dhesi, Z., Enne, V. I., O’Grady, J., Gant, V. & Livermore, D. M. Rapid and point-of-care testing in respiratory tract infections: an antibiotic guardian?. ACS Pharmacol. Transl. Sci. 3(3), 401–17 (2020).
pubmed: 32551433
pmcid: 7233852
doi: 10.1021/acsptsci.0c00027
Castro-Sánchez, E., Group WARNIN. Ten golden rules for optimal antibiotic use in hospital settings: The WARNING call to action. World J. Emerg. Surg. 18(50), 18–30 (2023).
Janssen, J. et al. Exploring the economic impact of inappropriate antibiotic use: The case of upper respiratory tract infections in Ghana. Antimicrob. Resist. Infect. Control. 11(1), 53 (2022).
pubmed: 35365210
pmcid: 8973739
doi: 10.1186/s13756-022-01096-w
Altaf, U., Saleem, Z., Akhtar, M. F., Altowayan, W. M., Alqasoumi, A. A., Alshammari, M. S. et al. Using culture sensitivity reports to optimize antimicrobial therapy: Findings and implications of antimicrobial stewardship activity in a hospital in Pakistan. Medicina (Kaunas) 59(7). (2023).
Tinker, N. J. et al. Interventions to optimize antimicrobial stewardship. Antimicrob Steward Healthc. Epidemiol. 1(1), e46 (2021).
pubmed: 36168471
pmcid: 9495515
doi: 10.1017/ash.2021.210
Abejew, A. A., Wubetu, G. Y. & Fenta, T. G. Assessment of challenges and opportunities in antibiotic stewardship program implementation in Northwest Ethiopia. Heliyon (2024).
Boltena, M. T. et al. Adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in sub-Saharan Africa: A systematic review and meta-analysis. J. Pharm. Policy Pract. 16(1), 137 (2023).
pubmed: 37936215
pmcid: 10629154
doi: 10.1186/s40545-023-00634-0
Gorgulho, A., Cunha, F., Alves Branco, E., Azevedo, A., Almeida, F., Duro, R. et al. Appropriateness of empirical prescriptions of ceftriaxone and identification of opportunities for stewardship interventions: A single-centre cross-sectional study. Antibiotics (Basel) 12(2) (2023).