A Point Prevalence Survey of antibiotics use patterns at Tanga Regional Referral Hospital in Tanzania

Objective: Antimicrobial resistance (AMR) is a major global health threat, driven in part by inappropriate antibiotic use. This study assessed the prevalence, patterns, and determinants of antibiotic prescription among inpatients at Tanga Regional Referral Hospital (RRH), Tanzania, using the World Health Organization (WHO) Point Prevalence Survey (PPS) methodology. Design: A cross-sectional PPS was conducted using the WHO tool. Descriptive statistics summarized prescribing patterns, and logistic regression identified factors associated with antibiotic use. Setting: Tanga RRH in Tanzania among hospitalized patients in April 2023. Results: Among 205 inpatients (60.5% female), 77.6% ( n = 159) received ≥1 antibiotic, with a mean of 2.1 agents per patient. Metronidazole (27.7%) and ceftriaxone (17.6%) were the most frequently prescribed antibiotics. Only 2.4% of prescriptions were supported by antimicrobial susceptibility testing. In multivariate analysis, the absence of a peripheral vascular catheter was independently associated with reduced odds of antibiotic use (aOR 0.16, 95% CI: 0.06–0.43). Although 89% of prescriptions followed the Tanzanian Standard Treatment Guidelines, prescribing patterns diverged from WHO stewardship targets: only 53.8% of antibiotics were from the Access group (below the ≥60% recommended threshold). In comparison, 44.4% belonged to the broader-spectrum Watch group. Conclusion: Antibiotic use in Tanga RRH was high, with limited microbiological guidance and heavy reliance on broad-spectrum Watch antibiotics, highlighting stewardship gaps. Strengthening antimicrobial stewardship and expanding diagnostic capacity are urgently needed to optimize antibiotic use and curb AMR in resource-limited settings.