Changing antibiotics prescribing practices in health centers of Khartoum State, Sudan
Abstract
Objective A major problem with inappropriate use of antibiotics is the emergence of resistance. Thus, cost-effective interventional strategies are required to improve their use. This study aimed to evaluate the effect of multifaceted interventions on prescribing practices of antibiotics in health centers of Khartoum State, Sudan.Methods Twenty health centers were randomly assigned to receive: (1) no intervention; (2) audit and feedback; (3) audit and feedback + seminar; or (4) audit and feedback + academic detailing. A total of 1,800 patient encounters, 30 from each health center, were randomly collected. The total number of encounters with antibiotics prescribed were determined in each health center and they were evaluated with regard to antibiotic choice, dose and duration of therapy before the study and at 1 and 3 months post-intervention.Results In comparison to the control group, the prescriber targeted interventions involving audit and feedback, together with academic detailing (4), reduced the mean number of encounters with an antibiotic prescribed by 6.3 and 7.7 (p<0.001) at 1 and 3 months post-intervention, respectively. In addition, the mean number of encounters with an inappropriate antibiotic with respect to diagnosis, doses and/ or duration of therapy was reduced by 5.3 and 5.9 (p<0.001) at 1 and 3 months post-intervention, respectively. For audit and feedback together with seminars (3) and for audit and feedback alone (2), the corresponding reductions were 5.3, 7.1, 4.4 and 5.1 (p<0.001) and 1.4, 2.8, 1.8 and 1.9 (p>0.05), respectively.Conclusion Inappropriate prescribing patterns of antibiotics in health centers of Khartoum State, Sudan, are alarmingly high. Multifaceted interventions involving audit and feedback combined with either academic detailing or seminars appear more effective in changing prescribing practices of antibiotics than audit and feedback alone.
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Awad 2006 found that adding seminars to audit and feedback reduced inappropriate prescribing of antibiotics in Sudan (adjusted change relative to baseline control = 26%; P < 0.001).
“Awad 2006 (adjusted change relative to baseline control = 26%; P < 0.001) found that adding seminars to audit and feedback reduced inappropriate prescribing of antibiotics in Sudan”
From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Awad 2006
Awad 2006 found a small effect on inappropriate antibiotic prescribing with academic detailing compared to audit and feedback alone (adjusted change relative to baseline performance in the audit and feedback alone arm = 29%, P < 0.001).
“Awad 2006 ‐ adjusted change relative to baseline performance in the audit and feedback alone arm = 29%, P < 0.001”
From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Awad 2006
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References 25 · Cited by 84
- Authors
- Awad, A. I., Eltayeb, I. B., & Baraka, O. Z.
- Affiliations
- Kuwait University (KW)
- University of Khartoum (SD)
- Corresponding author
- Awad, A. I.
- ORCID
- Awad, A. I.
- Venue
- European Journal of Clinical Pharmacology
- Published
- 2006-01-03
- Volume
- 62
- Issue
- 2
- Pages
- 135-142
- ISSN
- 0031-6970 (ISSN-L)
- 1432-1041
- OpenAlex
- W2062734487
- Cited by
- 84
- References
- 25
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 10 · 2022: 4 · 2021: 7 · 2020: 9 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 4 · 2012: 4
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- antibiotic prescribing, inappropriate prescribing, audit and feedback, academic detailing, seminars, multicomponent intervention, antimicrobial resistance, health centers, Khartoum State
- MeSH terms
- Anti-Bacterial Agents, Data Collection, Education, Medical, Continuing, Feedback, Humans, Medical Audit, Practice Patterns, Physicians', Drug Prescriptions, Primary Health Care, Sudan, Drug Resistance, Bacterial
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