Prescribing Patterns of Aminoglycoside Antibiotics in a Teaching Hospital in Sudan

2020 
Background: Aminoglycoside antimicrobials are widely used for the treatment of severe gram-negative bacterial infections. Their inappropriate use may result in treatment failure, development of resistant pathogens, and toxicity. Drug utilization evaluation of aminoglycosides can improve rational use. Purpose: This study intended to assess the prescribing patterns and potential problems associated with gentamicin and amikacin use. Methods: This prospective observational study was conducted at Soba University Hospital, Khartoum, Sudan. Patients’ demographics, clinical and prescription information were collected using a data collection form. Laboratory data of patients were collected from the patients' files. Ideal body weight was calculated to assess dose appropriateness, and adverse drug reactions were observed. Results: A total of 200 patients were included in the present study, two-thirds of the patients were prescribed gentamicin, while the remainder were given amikacin. Dosing was inappropriate in (60.6%) and (76.5%) of patients on gentamicin and amikacin respectively. Conventional dosing was used more commonly (67%) than extended dosing (33%). All indications for the use of these drugs were found to be appropriate. In (72%) of cases, both gentamicin and amikacin were prescribed based on microbiological sensitivity testing. Auditory function monitoring was only performed for neonates and infants. Nephrotoxicity was detected in 7 patients (9.3%), and ototoxicity in one patient (1.3%). Conclusion: Although prescription and dosing based on ideal body weight and microbiological data were reasonably common, higher compliance with recommended practice is needed in addition to therapeutic drug monitoring in order to ensure safe and effective treatment, and reduced antibiotic resistance.
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