title: Evaluation of ceftriaxone utilization in medical and emergency wards of Tikur Anbessa specialized hospital: a prospective cross-sectional study.
abstract: BACKGROUND
  Ceftriaxone is one of the most commonly used antibiotics due to its high antibacterial potency, wide spectrum of activity and low potential for toxicity. However, the global trend shows misuse of this drug. The aim of this study was to evaluate prospectively the appropriateness of ceftriaxone use in medical and emergency wards of Tikur Anbessa Specialized Hospital.
  
  
  METHODS
  A prospective cross-sectional study was conducted by reviewing medication records of patients receiving ceftriaxone during hospitalization at Tikur Anbessa Specialized Hospital between February 1 and June 30, 2014. Drug use evaluation was conducted to determine whether ceftriaxone was being used appropriately based on six criteria namely indication for use, dose, frequency of administration, duration of treatment, drug-drug interaction, culture and sensitivity test. The evaluation was made as per the protocol developed from current treatment guidelines.
  
  
  RESULTS
  The total of 314 records of patients receiving ceftriaxone was reviewed. The prescribing rate of ceftriaxone was found to be very high (58 % point prevalence). Ceftriaxone use was empiric in 274 (87.3 %) cases. The most common indication for ceftriaxone use was pneumonia; observed in 110 (35.0 %) cases. The most common daily dosage, frequency of administration and duration of treatment with ceftriaxone were 2 g (88.9 %), twice-daily (98.4 %) and 8-14 days (46.2 %), respectively. Inappropriate use of ceftriaxone was observed in most of cases (87.9 %), the greatest proportion of which was attributed to inappropriate frequency of administration (80.3 %), followed by absence of culture and sensitivity test (53.2 %).
  
  
  CONCLUSIONS
  This study revealed that the inappropriate use of ceftriaxone was very high in the medical and emergency wards of Tikur Anbessa Specialized Hospital. This may lead to emergence of resistant pathogens which in turn lead to treatment failure and increased cost of therapy. Therefore, adherence to current evidence-based guidelines is recommended.
authors.affiliation: Department of Pharmacy, Arsi University, Asela, Ethiopia. alemayehusileshi45@yahoo.com.
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Sileshi
authors.affiliation: Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. kadmasen@gmail.com.
authors.forename: Admasu
authors.initials: A
authors.lastname: Tenna
authors.affiliation: Department of pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. mamo.feyissa@aau.edu.et.
authors.forename: Mamo
authors.initials: M
authors.lastname: Feyissa
authors.affiliation: Department of pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. workineh.shibeshi@aau.edu.et.
authors.forename: Workineh
authors.initials: W
authors.lastname: Shibeshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors; D004334:Drug Administration Schedule; D004636:Emergency Service, Hospital; D005002:Ethiopia; D005260:Female; D006782:Hospitals, Special; D006784:Hospitals, Teaching; D006801:Humans; D057970:Inappropriate Prescribing; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone