PT  - JOURNAL ARTICLE
AU  - Abdu, Nuru
AU  - Idrisnur, Saleh
AU  - Tewelde, Tomas
AU  - Tesfamariam, Eyasu H
TI  - Antibiotic prescribing practice using WHO Access, Watch and Reserve classification and its determinants among outpatient prescriptions dispensed to elderly population in six community chain pharmacies in Asmara, Eritrea: a cross-sectional study
AID  - 10.1136/bmjopen-2024-085743
DP  - 2024 Jun 01
TA  - BMJ Open
PG  - e085743
VI  - 14
IP  - 6
4099  - http://bmjopen.bmj.com/content/14/6/e085743.short
4100  - http://bmjopen.bmj.com/content/14/6/e085743.full
SO  - BMJ Open2024 Jun 01; 14
AB  - Objective To assess antibiotic prescribing practice and its determinants among outpatient prescriptions dispensed to the elderly population.Design A prescription-based, cross-sectional study.Setting Six community chain pharmacies in Asmara, Eritrea.Participants All outpatient prescriptions dispensed to the elderly population (aged 65 and above) in the six community chain pharmacies in Asmara, Eritrea.Data collection and analysis Data were collected retrospectively, between 16 June 2023 and 16 July 2023. Antibiotic prescribing practice was assessed using the 2023 World Health Organization (WHO) Access, Watch and Reserve (AWaRe) classification system. Descriptive statistics and logistic regression were performed using IBM SPSS (V.26.0). P values less than 0.05 were considered as significant.Results Of the 2680 outpatient prescriptions dispensed to elderly population, 35.8% (95% CI: 34.0, 37.6) contained at least one antibiotic. Moreover, a total of 1061 antibiotics were prescribed to the elderly population. The most commonly prescribed antibiotics were ciprofloxacin (n=322, 30.3%) and amoxicillin/clavulanic acid (n=145, 13.7%). The Access category accounted for the majority of antibiotics (53.7%) with 32.1% from the Watch category. Prescriber qualification (Adjusted Odds Ratio (AOR)= 0.60, 95% CI: 0.44, 0.81) and polypharmacy (AOR= 2.32, 95% CI: 1.26, 4.27) were significant determinants of antibiotic prescribing in the elderly population. Besides, sex (AOR=0.74, 95% CI: 0.56, 0.98), prescriber qualification (AOR=0.49, 95% CI: 0.30 to0.81) and level of health facility (AOR 0.52, 95% CI 0.34 to 0.81) were significant determinants of a Watch antibiotic prescription.Conclusion Antibiotics were prescribed to a considerable number of the elderly population, with more than half of them falling into the Access category. Further efforts by policy-makers are needed to promote the use of Access antibiotics while reducing the use of Watch antibiotics to mitigate risks associated with antimicrobial resistance.All data relevant to the study are included in the article or uploaded as online supplemental information.