Prescribing pattern and associated factors in community pharmacies: A cross-sectional study using AWaRe classification and WHO antibiotic prescribing indicators at Dire Dawa, Ethiopia

Abstract Background: Antibiotics are more likely to trigger the development of antimicrobial resistance than other medications. Thus, they need to be prescribed, dispensed, and administered with greater caution. Timely evidence on medicine use, prescribing patterns, and the factors affecting the prescribing of an antibiotic would help decision-makers draft guidelines that would enable a more rational use of medicines. Methods: Prospective and cross-sectional study was conducted in seven community pharmacies in Dire Dawa to assess current prescribing practices, including antibiotic use and associated factors. Using stratified random sampling techniques, 1200 encounters were reviewed between October 1 and October 31, 2022 and SPSS version 27 was used for descriptive statistics and logistic regression. Results: The average medications per prescription was 1.96 and antibiotics were included in 47.83% of encounters while 43.03% were prescribed from Watch group. In 13.5% of the encounters, injections were administered. In multivariate models, patient age, gender, and the number of medications prescribed were all substantially related to the prescription of antibiotics. Antibiotics were about 2.5 times more likely to be prescribed to patients under the age of 18 than to subjects 65 and older (AOR: 2.51, 95% CI: 1.62-2.52; P <.001). Men were also more likely than women to receive an antibiotic prescription (AOR: 1.74, 95%CI: 1.18–2.33; P = 0.011). Subjects who those who received more than two drugs were 2.96 times more likely to receive an antibiotic (AOR: 2.96, 95%CI: 1.77–6.55; P = 0.003). The probabilities of prescribing antibiotics increased by 2.57 units for every unit increase in the number of medications (COR: 2.57; 95%CI: 2.16-3.47; P = 0.002). Conclusions: According to this study, the amount of prescriptions with antibiotics at community pharmacies much higher than the WHO standard (20–26.2%). Additionally, 13.5% of encounters involved an injection, which is comparable to the World Health Organization standard of 13.4-24.1%. The prescribing of antibiotics was significantly correlated with the patient's age, gender, and number of medications.