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Pattern of antibiotic usage and predictors of hospital outcome among patients with systemic bacterial infection in Nekemte referral Hospital, Western Ethiopia.

Getachew Alemkere, Getu Bayisa, Abrham Belachew

Objective: Pattern of antibiotic usage and predictors of hospital outcome among patients with presumed systemic bacterial infection in Nekemte Referral Hospital Western Ethiopia. Methods: An institution based prospective observational study was performed from December 1 to March 30, 2017 in the internal medicine wards of Nekemte Referral Hospital. Patients who had presumed systemic bacterial infections were strictly followed. Data was collected on demographic, disease and drug related factors using a data abstraction format. Antibiotic use practice was described and predictors for mortality and length of stay were identified. Descriptive statistics and binary logistic regression were used for statistical analysis. Results: Females accounted for about 55% of the total 193 study participants whose mean (± SD) age was 39.97 ± 17.12. More than half (58.6%) of the participants had presumed systemic bacterial infections on admission. Whilst pneumonia was the first most prevalent infection presumed (47.7%), cephalosporins were the most widely prescribed (66.7%) class of drugs. Only one culture and 8 gram stain reports were documented and all the drugs were empirically used. About 8% of the wards patients were died during the in-hospital stay. The mean (± SD) inhospital length of stay was 6.98 ± 3.22 days (range: 3-18). While presence of a medical device was a positive predictor (AOR=4.50, 95% CI: 1.09, 18.60, p=0.038) and prolonged length of stay was the negative predictor (AOR=0.22, 95% CI: 0.05, 0.90, p=0.035) of mortality. On the other hand only presence of multidrug resistance (MDR) risk (AOR=6.14, 95% CI: 1.68, 22.41, p=0.006) was positively associated with prolonged in-hospital length of stay. Conclusion: Generally, these observations showed that all patients with systemic bacterial infection received antibiotics on an empiric basis. Broad spectrum third generation cepalosporins were the most commonly used drugs. These warrant an appropriate antimicrobial use policy in the context of resource-limited settings.