Abstract
Background
The burden of antibiotic prescription in Uganda ranges between 12–79%, and compliance with the Uganda treatment guidelines (UCG) is still low; at 30%. There is limited information about antibiotic prescription levels and their appropriateness in public health facilities. This study, therefore, aimed to determine the prevalence of antibiotic prescription, compliance with the Uganda treatment guidelines; and factors associated with antibiotic prescription among outpatients at Mulago National Referral Hospital, Uganda.
Methods
We employed a cross-sectional design, and collected quantitative data at Mulago National Referral Hospital, among 2480 outpatients. We used a data abstraction tool to collect data from systematically sampled patient prescriptions. Ethical approval was obtained from the Mulago Hospital Research and Ethics Committee, and permission was sought from the Uganda National Council of Science and Technology (Reference: HS3440ES). Data were entered into Epidata software, and analysed in STATA, using Modified Poisson regression.
Results
The median age of 2480 participants was 62 years (IQR: 56–68), and 60.6% (1501/2479) were 50 and older. The prevalence of antibiotic prescription among outpatients was 60.4% (1479/2480). The compliance with the UCG was 57.5% (861/1479). The factors associated with antibiotic prescription were; prescription from the directorate of surgery (aPR: 0.995; 95%CI:0.919, 0.993), bacterial infection diagnosis (aPR: 8.083; 95%CI: 6.833, 9.560), prescription of three or more drugs (aPR: 1.133, 95%CI: 1.093, 1.175), patient age of 6 to 17 years (aPR:1.052; 95%CI: 0.991, 1.118), and gender (aPR: 1.012; 95%CI:0.979, 1.046),
Conclusion
Antibiotic prescription prevalence was high while compliance to the UCG was moderate. All prescribers should present their authentic signatures to the pharmacy department to strengthen therapeutic intervention. Constant availability of laboratory reagents in the hospital; and refresher training in rational prescription writing are needed. Sensitization of the public about disease preventive measures should be strengthened. The current UCG 2023 copies should be available to all prescribers, and antibiotic prescriptions among inpatients should be investigated.