An assessment of the prevalence and treatment outcomes of multiple antibiotic prescribing vis-`a-vis the appropriateness of antibiotic prescriptions in the empirical treatment of infections: across-sectional study from Lesotho

Abstract

Purpose: The study had the objective of evaluating the prevalence and effectiveness of healthcare providers use of multiple antibiotics in the empiric treatment of infections. Methods: Three hundred and seven (307) antibiotic prescriptions from inpatient departments of five selected hospitals in Lesotho were assessed for their appropriateness. Antibiotic treatment success rates among patient groups and subgroups treated with antibiotic prescription categories considered appropriate and in appropriate and with specific numbers of antibiotics were determined. Correlations or associations of numbers of antibiotics per prescription and relevant variables were determined and used to evaluate the effects of multiple antibiotic prescribing on treatment outcomes. Results: Single antibiotics were almost prescribed for clinical conditions where prescribes had not absolutely identified bacteria pathogens as aetiologies of treated infections. Greater numbers of prescribed antibiotics were associated with inappropriate use of the agents in the empiric treatment of infections. Appropriateness rather than numbers of prescribed antibiotics correlated positively with treatment outcomes. Conclusion: no categorical relationship appears to exist between the number of antibiotics prescribed and treatment outcome. Prescribing higher numbers of antibiotics did not produce higher favorable treatment outcomes as compared with prescribing antibiotics appropriately.