Menyfah Al Anazi
Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia
Title: Incidence and predictors of antibiotic prescription errors in an emergency department of a tertiary care facility, central Saudi Arabia
Biography
Biography: Menyfah Al Anazi
Abstract
Background: Inappropriate Antibiotic (ATB) prescription threatens patients with adverse drug reactions, bacterial resistance, and subsequently elevated hospital costs. Aim of this study was to assess the incidence types of ATB prescription errors and identify their associated predictors among patients admitted to an emergency department at king Abdulaziz medical city in Riyadh. Methods: A retrospective cohort study was conducted by chart-reviewing all patients with infectious complaints over 3 months. Patient characteristics (age, gender, weight, allergy, infection type) and ATB prescription characteristics (class, dose, frequency, duration) were evaluated for appropriateness based on internationally recognized drug guidebooks. Descriptive and analytic statistics were applied. Signifi cance was set at p-value<0.05. Results: Total of 5,752 patients had equal distribution by gender(males 49%,females 51%) and age groups (adults 61%,pediatrics 39%), of which 55% complained respiratory tract infections(RTIs), 25% urine tract infections(UTIs), 11% otitis media (OM). Broad spectrum ATBs were prescribed for 77% of the cases. Prior prescription in pediatrics, 82% had weight taken. Incidence of ATB prescription with at least one type of error was 58% in pediatrics and 39% in adults. Errors were in selection of ATB class (2%), Dose (21%), Frequency (6%), and Duration(25%). Dose/duration errors were signifi cantly predominant among pediatrics (p=0.0001/p<0.0001 respectively). Selection error was higher among adults (p=0.002). Age stratifi cation and binary logistic regression were applied. Signifi cant predictors of errors in both age groups were associated with penicillin prescriptions (adult: p<0.001 ,adj.RR=3.09), (pediatric :p<0.001,adj.RR=4.10) compared to cephalosporin & with RTIs (adults: p<0.001,adj. RR=2.82), (pediatrics: p=0.039,adj.RR=1.37) compared to UTIs & with obtaining weight for pediatrics prior prescription (p<0.001,adj.RR=1.83) compared to those who didn’t. Conclusion: Incidence of ATB prescription errors in this ED was alerting and high compared to similar studies. Setting clear and accessible guidelines for antibiotic prescriptions especially for narrow spectrums and UTI infections is recommended. Inappropriate antibiotic prescription is the responsibility of institution, and community as well, to reduce the emerging resistant bacteria, and cost especially.
