Prescribing patterns of antimicrobials according to the WHO AWaRe classification at a tertiary referral hospital in the southern highlands of Tanzania

Anthony Nsojo; Lutengano George; Davance Mwasomola; Joseph Tawete; Christopher H Mbotwa; Clement N Mweya; Issakwisa Mwakyula

doi:10.1016/j.infpip.2024.100347

Prescribing patterns of antimicrobials according to the WHO AWaRe classification at a tertiary referral hospital in the southern highlands of Tanzania

Infect Prev Pract. 2024 Feb 6;6(2):100347. doi: 10.1016/j.infpip.2024.100347. eCollection 2024 Jun.

Authors

Anthony Nsojo^{1

2}, Lutengano George², Davance Mwasomola², Joseph Tawete², Christopher H Mbotwa¹, Clement N Mweya^{1

3}, Issakwisa Mwakyula^{1

2}

Affiliations

¹ Mbeya College of Health and Allied Sciences, University of Dar es Salaam, P. O. Box 608, Mbeya, Tanzania.
² Mbeya Zonal Referral Hospital, P. O. Box 419, Mbeya, Tanzania.
³ Mbeya Medical Research Centre, National Institute for Medical Research, P. O. Box 2410, Mbeya, Tanzania.

Abstract

Background: Antimicrobial consumption continues to rise globally and contributes to the emergence and spread of antimicrobial resistance. This study aimed to evaluate antimicrobial prescribing patterns in a selected tertiary hospital in Tanzania.

Methods: This cross-sectional study was conducted for one year (September 2021-September 2022) at Mbeya Zonal Referral Hospital, a public hospital in the southern highlands zone of Tanzania. Data on clinical diagnosis, laboratory tests, prescribed antimicrobials, and prescribers' designations were collected through a custom eMedical system, aligning antimicrobials with the WHO's 2021 AWaRe classification. Descriptive analysis was performed to assess the pattern of antimicrobial prescriptions.

Results: Of 2,293 antimicrobial prescriptions, 62.41% were ACCESS, 37.42% were WATCH, and 0.17% fell in the RESERVE categories. Metronidazole, accounting for 23.8%, was the most commonly prescribed antimicrobial. More than 50% of the ACCESS and WATCH prescriptions were justified by laboratory diagnosis and were predominantly prescribed by clinicians. A very small proportion of prescriptions (<1%) were informed by culture and sensitivity (C/S) testing. The Paediatric department had the majority of WATCH prescriptions (72.2%).

Conclusion: The prescribing patterns at the study hospital generally align with WHO AWaRe guidelines, potentially mitigating antimicrobial resistance. Nevertheless, the scarcity of culture and sensitivity testing is a concern that warrants targeted improvement.

Keywords: Antimicrobials; Prescribing patterns; Tanzania; Tertiary referral hospital; WHO AWaRe classification.