Adherence to Guidelines for Assessment and Empiric Antibiotics Recommendations for Community-Acquired Pneumonia at Ambo University Referral Hospital: Prospective Observational Study.

OBJECTIVE: The high incidence and substantial morbidity and mortality associated with community-acquired pneumonia necessitate an accurate assessment and appropriate management of patients. This observational prospective study aimed to evaluate the physicians' adherence to the Ethiopian Standard Treatment Guideline for assessment and an empiric antibiotic selection for Community-acquired pneumonia. RESULTS: The study indicated that the pneumonia severity assessment tool, CURB-65 score, was never used. Of 141 patients referred to an admitting diagnosis of severe community-acquired pneumonia, only 50 were subsequently found to satisfy the guideline criteria, over-diagnosis of 41.9%. Large proportions of the participants (130, 60%) were prescribed antibiotics in the last three months. The most commonly prescribed single antibiotic was Ceftriaxone (47, 21.7%), while ceftriaxone plus azithromycin was the most common combination, 110 (50.7%). In general, the extent of non-adherence to the national guideline for the use of antibiotics was 36.4%. In conclusion, the use of CRB65 scores was uncommon in the study setting. Poor adherence to Ethiopian Standard Treatment Guideline regarding the decision of hospital admission (41.9%) and the antimicrobial selection (36.4%) was determined.

Exit-Knowledge About Dispensed Medications and Associated Factors Among Patients Attending the Outpatient Pharmacy of Ambo General Hospital, Western Ethiopia.

BACKGROUND: Insufficient knowledge of patients about their dispensed medications may result in inappropriate use of medication which can lead to treatment failure and poor therapeutic outcome. PURPOSE: This study aimed to determine the exit-knowledge level and its determinants among patients attending outpatient pharmacy of the Ambo General Hospital. PATIENTS AND METHODS: Hospital-based cross-sectional study was conducted on 400 study participants who visited the outpatient pharmacy in Ambo General Hospital from October to December 2019. Face-to-face interview was conducted using structured questionnaires to assess the exit-knowledge of the patients about their dispensed medication at the pharmacy exit. A binary logistic regression was employed to determine factors associated with the exit-knowledge. The association was statistically significant at 95% of confidence interval with a p-value less than 0.05. RESULTS: A total of 400 patients participated in the study with a 100% response rate. Of the total, 222 (55.5%) patients had sufficient exit-knowledge about their dispensed medication. Patients in the age group of 19-29 (AOR=3.1; 95% CI (1.7-5.6) and 49 -59 (AOR = 3.7; 95% CI (2.3-6.0)) had greater exit-knowledge than the elderly participants (>60 years). Participants who reported the comfort of the waiting area was not suitable had lower odds of sufficient exit-knowledge (AOR= 0.7; 95% CI (0.2-3.0)) in comparison to those who reported a suitable waiting area. Lower odds of sufficient exit-knowledge (AOR=0.4; 95% CI (0.3-0.7)) was determined among those who responded fairly clarity of the dispensers guidance in comparison with those reported clear guidance. The gender and the residence of the participants were also had a significant association with the exit-knowledge level. CONCLUSION: Modest number of the patients had sufficient exit-knowledge of their dispensed medication. Age, gender, residence, perceived comfort of the waiting area and perceived clarity of the pharmacists' guidances were significantly associated with the exit-knowledge.