Objectives: Antibiotics have diminished mortality rates associated with bacterial infections. However, their misuse worsens antimicrobial resistance. This study aimed to evaluate antibiotic prescribing patterns using World Health Organization/International Network for Rational Use of Drug prescribing indicators and its determinants at public hospitals in Eastern Tigrai, Ethiopia. Methods: A multicenter cross-sectional study was done among encounters prescribed from 1 December 2023 to 30 November 2024 at Doctor Tsegay, Freweyni, and Fre-Semaetat Primary Hospitals. A total of 1800 encounters were selected using systematic random sampling. Data collected from 01 December 2024 to 31 January 2025 were analyzed using SPSS version 21. Binary logistic regression was done to identify determinants of antibiotic prescribing setting statistical significance at p < 0.05. A model fitness test was performed using the Hosmer–Lemeshow goodness-of-fit. Results: Antibiotics were prescribed in 65.7% of encounters (1183/1800), totaling 1465 antibiotics. The mean prescribing indicators were 1.24 (Standard deviation 0.48) antibiotics per encounter, and 26.4% of encounters included an injection. Nearly all antibiotics were prescribed from the essential medicine list (99.6%) and by generic name (97.5%). Overall, 67.0% of antibiotics were classified under the “Access” group and 33.0% under the “Watch” group, with none from the “Reserve” group. Factors significantly associated with antibiotic prescribing included being under 18 years of age (adjusted odds ratio = 2.6; 95% confidence interval: 1.54–4.2), receiving ⩾3 drugs (adjusted odds ratio = 7.8; 95% confidence interval: 5.4–11.4), having ⩾2 diseases (adjusted odds ratio = 2.1; 95% confidence interval: 1.27–3.4), and presenting diseases of the genitourinary system (adjusted odds ratio = 9.4; 95% confidence interval: 3.9–22.8). Conclusion: Antibiotic prescribing practices were not aligned with World Health Organization standards, indicating substantial overuse. Such patterns may contribute to the worsening of antimicrobial resistance. Strengthening adherence to World Health Organization and national treatment guidelines is essential to promote rational use of antibiotics in these hospitals.
Hailesilase et al. (Sun,) studied this question.