Author(s)

Steward Mudenda^1*, Mary Chomba¹, Billy Chabalenge², Christabel Nang’andu Hikaambo¹, Michelo Banda¹, Victor Daka³, Annie Zulu⁴, Abraham Mukesela⁵, Maxwell Kasonde⁵, Peter Lukonde⁵, Enock Chikatula⁶, Lloyd Matowe⁷, Ronald Kampamba Mutati¹, Tyson Lungwani Muungo¹, Tobela Mudenda⁸, Shafiq Mohamed⁹, Scott Matafwali¹⁰

¹Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.
²Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka, Zambia.
³Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia.
⁴Bell Pharmacy, Kabulonga Centro Mall, Lusaka, Zambia.
⁵Ministry of Health Headquarters, Ndeke House, Lusaka, Zambia.
⁶Department of Pharmacy, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia.
⁷Faculty of Pharmacy, School of Pharmacy, Eden University, Lusaka, Zambia.
⁸Department of Pathology, Ndola Teaching Hospital, Ndola, Zambia.
⁹Remedium Pharmaceuticals Limited, Lusaka, Zambia.
¹⁰Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.

Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely; Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.

Antibiotic Prescribing, Antimicrobial Resistance, Antimicrobial Stewardship, AWaRe Classification, Prescribing Patterns, Primary Healthcare, Surveillance, Zambia

Mudenda, S. , Chomba, M. , Chabalenge, B. , Hikaambo, C. , Banda, M. , Daka, V. , Zulu, A. , Mukesela, A. , Kasonde, M. , Lukonde, P. , Chikatula, E. , Matowe, L. , Mutati, R. , Muungo, T. , Mudenda, T. , Mohamed, S. and Matafwali, S. (2022) Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia. Pharmacology & Pharmacy, 13, 379-392. doi: 10.4236/pp.2022.1310029.