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Changing antibiotics prescribing practices in health centers of Khartoum State, Sudan

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

A major problem with inappropriate use of antibiotics is the emergence of resistance. Thus, cost-effective interventional strategies are required to improve their use. This study aimed to evaluate the effect of multifaceted interventions on prescribing practices of antibiotics in health centers of Khartoum State, Sudan.

Methods

Twenty health centers were randomly assigned to receive: (1) no intervention; (2) audit and feedback; (3) audit and feedback + seminar; or (4) audit and feedback + academic detailing. A total of 1,800 patient encounters, 30 from each health center, were randomly collected. The total number of encounters with antibiotics prescribed were determined in each health center and they were evaluated with regard to antibiotic choice, dose and duration of therapy before the study and at 1 and 3 months post-intervention.

Results

In comparison to the control group, the prescriber targeted interventions involving audit and feedback, together with academic detailing (4), reduced the mean number of encounters with an antibiotic prescribed by 6.3 and 7.7 (p<0.001) at 1 and 3 months post-intervention, respectively. In addition, the mean number of encounters with an inappropriate antibiotic with respect to diagnosis, doses and/ or duration of therapy was reduced by 5.3 and 5.9 (p<0.001) at 1 and 3 months post-intervention, respectively. For audit and feedback together with seminars (3) and for audit and feedback alone (2), the corresponding reductions were 5.3, 7.1, 4.4 and 5.1 (p<0.001) and 1.4, 2.8, 1.8 and 1.9 (p>0.05), respectively.

Conclusion

Inappropriate prescribing patterns of antibiotics in health centers of Khartoum State, Sudan, are alarmingly high. Multifaceted interventions involving audit and feedback combined with either academic detailing or seminars appear more effective in changing prescribing practices of antibiotics than audit and feedback alone.

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Acknowledgements

This study received financial support from the Sudan Essential Drug Programme. The invaluable assistance of local health authorities through giving their approval and permission for this study is highly acknowledged. We are also grateful to the prescribers who agreed to participate in the study.

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Authors and Affiliations

  1. Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait

    A. I. Awad

  2. Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, P.O. Box 1996, Khartoum, Sudan

    I. B. Eltayeb

  3. Department of Internal Medicine and Applied Therapeutics, Faculty of Medicine, University of Khartoum, P.O. Box 1063, Khartoum, Sudan

    O. Z. Baraka

Authors
  1. A. I. Awad
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  2. I. B. Eltayeb
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  3. O. Z. Baraka
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Corresponding author

Correspondence to A. I. Awad.

Additional information

The study was conducted in Khartoum state, Sudan. Data interpretation and writing were undertaken in Faculty of Pharmacy, Kuwait University and University of Khartoum

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Awad, A.I., Eltayeb, I.B. & Baraka, O.Z. Changing antibiotics prescribing practices in health centers of Khartoum State, Sudan. Eur J Clin Pharmacol 62, 135–142 (2006). https://doi.org/10.1007/s00228-005-0089-4

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  • DOI: https://doi.org/10.1007/s00228-005-0089-4

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