Antibiotic prescribing patterns at outpatient in Nanyuki Teaching and Referral Hospital, Laikipia County, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260030Keywords:
Antibiotics, Prescribing, Patterns, OutpatientsAbstract
Background: Antibiotics are the most commonly and often imprudently used therapeutics globally. The study of use of antibiotic is vital, as irrational use is a global public health threat. Very few studies are done on the out-patient prescribing patterns of antibiotic in Kenya. This study aimed to evaluate the antibiotic prescription patterns in the outpatient department in Nanyuki Teaching and Referral Hospital in Laikipia.
Methods: We adopted a point prevalence study using the out-patient global PPS tool. Important variables had data represented in frequency tables and graphs. Chi-square determined the association between categorical variables and t-test for continuous variables. Confidentiality of data will be maintained throughout the study and STATA was used for analysis.
Results: The point prevalence of antimicrobial use was (29.1%) patients who were receiving at least one antimicrobial agent at the time of the survey. Penicillins were the most commonly prescribed class (41.5%) followed by cephalosporins (21.6%). By age group, children had the highest proportion of prescriptions at 40.4%. Most common diagnostic indication was community acquired infection 89.5% that had least one antimicrobial while the highest infection is respiratory infections, at 26.3% of the cases, followed by gastrointestinal infections 19.8%. Cultures were rarely performed before initiating therapy, accounting for 1.8% only. Only 11.7%, of prescriptions were guided by existing local protocols.
Conclusions: This study recommends strengthening antimicrobial stewardship (AMS) committees to routinely review prescribing trends, alongside expanding diagnostic services as culture and sensitivity facilities to support evidence-based antibiotic use. Additionally, improve the utilization of guidelines in treatment.
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References
Walter E, Gibson O. The efficacy of antibiotics in reducing morbidity and mortality from heatstroke - A systematic review. J Therm Biol. 2020;88. DOI: https://doi.org/10.1016/j.jtherbio.2020.102509
World Health Organization. Pocket book of hospital care for children: Second edition. 2013. Available at: https://www.who.int/publications/i/item/978-92-4-154837-3. Accessed on 12 November 2025.
Zanichelli V, Monnier AA, Gyssens IC, Adriaenssens N, Versporten A, Pulcini C, et al. Variation in antibiotic use among and within different settings: a systematic review. J Antimicrob Chemother. 2018;73:vi17-29. DOI: https://doi.org/10.1093/jac/dky115
Arcy ND, Ashiru-oredope D, Olaoye O, Afriyie D, Akello Z, Ankrah D, et al. Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented. Antibiotics (Basel). 2021;10(9):1122. DOI: https://doi.org/10.3390/antibiotics10091122
Okoth C, Opanga S, Okalebo F, Oluka M, Baker Kurdi A, Godman B. Point prevalence survey of antibiotic use and resistance at a referral hospital in Kenya: findings and implications. Hosp Pract (1995). 2018;46(3):128-36. DOI: https://doi.org/10.1080/21548331.2018.1464872
Porto APM, Goossens H, Versporten A, Costa SF; Brazilian Global-PPS Working Group. Global point prevalence survey of antimicrobial consumption in Brazilian hospitals. J Hosp Infect. 2020;104(2):165-71. DOI: https://doi.org/10.1016/j.jhin.2019.10.016
Elton L, Thomason MJ, Tembo J, Velavan TP, Pallerla SR, Arruda LB, et al. Antimicrobial resistance preparedness in sub-Saharan African countries. Antimicrob Resist Infect Control. 2020;9(1):1-11. DOI: https://doi.org/10.1186/s13756-020-00800-y
Republic of Kenya. National Policy on Prevention and Containment of Antimicrobial Resistance. 2017. Available at: www.health.go.ke. Accessed on 30 October 2025.
Goossens H. The Global-PPS on antimicrobial consumption and resistance will allow for targeted quality improvements, the development of local prescribing guidelines, education and practice changes, and also for measuring the impact of these interventions," said. 2023. Available at: www.biomerieux.com. Accessed on 30 October 2025.
Ata M. Antibiotics Prescribing Pattern at Outpatient Department of a Tertiary Medical College Hospital. 2018;17. Available at: www.banglajol.info/index. php/CMOSHMCJ. Accessed on 30 October 2025. DOI: https://doi.org/10.3329/cmoshmcj.v17i2.39775
Zhang HL, Bodinayake C, Wijayaratne GB, Jayatissa P, Piyasiri DLB, Kurukulasooriya R, et al. Point-prevalence survey of outpatient antibiotic prescription at a tertiary medical center in Sri Lanka: opportunities to improve prescribing practices for respiratory illnesses. BMC Infect Dis. 2021;21(1). DOI: https://doi.org/10.1186/s12879-021-05804-6
Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14(8):742-50. DOI: https://doi.org/10.1016/S1473-3099(14)70780-7
Manirakiza A, Maru SM, Nyamu DG, Bizimana T, Nimpagaritse M. Antimicrobial prescribing patterns among pediatric outpatient encounters in primary healthcare centers in Bujumbura Mairie, Burundi. BMC Prim Care. 2025;26(1):1-9. DOI: https://doi.org/10.1186/s12875-025-02944-5
Maina M, Mwaniki P, Odira E, Kiko N, McKnight J, Schultsz C, et al. International Journal of Infectious Diseases Antibiotic use in Kenyan public hospitals: Prevalence, appropriateness and link to guideline availability. Int J Infect Dis. 2020;99:10-8. DOI: https://doi.org/10.1016/j.ijid.2020.07.084
Sapkota K, Pokharel D, Basel S, Dhakal B. Antibiotics Prescribing Pattern of Outpatients in a Tertiary Level Hospital in Nepal. J Coll Med Sci. 2023;19(4):392-8. DOI: https://doi.org/10.3126/jcmsn.v19i4.58869
AWaRe classification of antibiotics for evaluation and monitoring of use. 2023. Available at: https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2023.04. Accessed on 30 October 2025.
Darkwah TO, Afriyie DK, Sneddon J, Cockburn A, Opare-Addo MNA, Tagoe B, et al. Assessment of prescribing patterns of antibiotics using National Treatment Guidelines and World Health Organization prescribing indicators at the Ghana Police Hospital: a pilot study. Pan Afr Med J. 2021;39:222. DOI: https://doi.org/10.11604/pamj.2021.39.222.29569
Kiener M, Ichura C, Ndenga BA, Mutuku FM, Winter CA, Okuta V, et al. Antibiotic prescribing patterns at outpatient clinics in Western and Coastal Kenya. PLOS Glob Public Heal. 2025;5(1). DOI: https://doi.org/10.1371/journal.pgph.0004109
Lydia M. Antibiotic Prescribing Patterns at Rift Valley Provincial. 2017. Available at: https://ereposit ory.uonbi.ac.ke/bitstream/handle/11295/102500/Momanyi_Antibiotic%20Prescribing%20Patterns%20at%20Rift%20Valley%20Provincial%20General%20Hospital%20a%20Point%20Prevalence%20Survey.pdf?sequence=1. Accessed on 30 October 2025.
Seni J, Mapunjo SG, Wittenauer R, Valimba R, Stergachis A, Werth BJ, et al. Antimicrobial use across six referral hospitals in Tanzania: A point prevalence survey. BMJ Open. 2020;10(12):1-9. DOI: https://doi.org/10.1136/bmjopen-2020-042819
Yimenu DK, Emam A, Elemineh E, Atalay W. Assessment of Antibiotic Prescribing Patterns at Outpatient Pharmacy Using World Health Organization Prescribing Indicators. J Prim Care Commun Health. 2019;10. DOI: https://doi.org/10.1177/2150132719886942
Nsojo A, George L, Mwasomola D, Tawete J, Mbotwa CH, Mweya CN, et al. 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;6(2):100347. DOI: https://doi.org/10.1016/j.infpip.2024.100347
Bulcha B, Motuma B, Tamiru Y, Gurmessa WT. Assessment of Knowledge, Attitude and Practice (KAP) Regarding Antimicrobial Usage and Resistance Among Animal Health Professionals of East Wallaga Zone, Oromiya, Ethiopia. Vet Med Res Rep. 2024;15:57-70. DOI: https://doi.org/10.2147/VMRR.S443043
Dobson EL, Klepser ME, Pogue JM, Labreche MJ, Adams AJ, Gauthier TP, et al. Outpatient antibiotic stewardship: Interventions and opportunities. J Am Pharm Assoc. 2017;57(4):464-73. DOI: https://doi.org/10.1016/j.japh.2017.03.014
Mudenda S, Chomba M, Chabalenge B, Hikaambo CN, Banda M, Daka V, et al. 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. Pharmacol Pharm. 2022;13(10):379-92. DOI: https://doi.org/10.4236/pp.2022.1310029
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