AI Insight
This cross-sectional study assessed antibiotic prescribing practices across 30 public healthcare facilities in Zanzibar, Tanzania, analyzing 3,455 prescriptions and surveying prescribers' knowledge and adherence to treatment guidelines. While most prescriptions (99.9%) included documented diagnoses and 65.7% followed standard treatment guidelines, key WHO indicators for rational prescribing were not met, with only 65.9% using generic names and significant variation in prescriber knowledge levels (24.3% had low knowledge). Beta-lactam antibiotics were the most frequently prescribed class, and although 90% of prescribers reported guideline adherence, actual prescribing practices revealed suboptimal rationality.
Why it matters
Irrational antibiotic prescribing contributes to antimicrobial resistance, a critical global health threat. Identifying specific gaps in prescriber knowledge and adherence to guidelines in resource-limited settings like Zanzibar can inform targeted interventions to improve antibiotic stewardship and preserve antibiotic effectiveness.
Understand the Science
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
This study aims at assessing the rational antibiotic medicine prescribing in public health care facilities in Zanzibar, Tanzania. The study employed a descriptive and cross-sectional study with a quantitative approach in collecting and analyzing data. The study targeted all 30 health care facilities in the western urban region of Zanzibar together with all prescribers and prescriptions prescribed during the study period. Prescriptions were selected by using probability systematic sampling techniques from selected public health facilities. The study found that, 3,455 (99.9%) recorded prescription encounters had a documented diagnosis, indicating comprehensive record-keeping. On average, 1.1 (SD= {+/-}0.3) antibiotics were prescribed per prescription encounter, with 2,277 (65.9%) prescribed generic names. Injectable antibiotics were recorded in 166 (4.8%) of prescriptions, while 2,270 (65.7%) of prescriptions adhered to the Zanzibar Standard Treatment Guidelines (STG). The overall mean knowledge score among prescribers was 6.1 (SD = 0.89). 24.3% of prescribers had low knowledge ([≤]5 points), 41.4%had medium knowledge (6 points), and 34.3%had high knowledge ([≥]7 points). A majority of prescribers (90%) reported that they always adhere to the Zanzibar Standard Treatment Guidelines (ZSTG) and Zanzibar Essential Medicines List (ZEML) when prescribing antibiotics. 1.4% of prescribers acknowledged that they sometimes prescribe antibiotics even when unnecessary. Regarding antibiotic selection, 45.7% of prescribers prescribe only generic antibiotics. The study also found that Beta-Lactam antibiotics were the most prescribed, with 98.6% of prescribers confirming their frequent use. According to the results, most of the prescribing indicators in these health facilities did not meet the WHO’s standard requirements, thus being irrational (poor rational prescribing).
Source: INVESTIGATING RATIONAL ANTIBIOTIC PRESCRIBING IN PUBLIC HEALTH CARE FACILITIES OF ZANZIBAR TANZANIA