Inappropriate antibiotic prescribing in Ethiopian hospitals: a systematic review
Abstract
Introduction: Inappropriate antibiotic prescribing is a major driver of antimicrobial resistance globally, and its consequences are more severe in low- and middle-income countries such as Ethiopia. Although antibiotics are commonly prescribed for inpatients in Ethiopian hospitals, evidence on their appropriateness remains limited and inconsistent.
Aim: This systematic review aimed to assess the prevalence, prescribing characteristics, and factors associated with inappropriate antibiotic prescribing in Ethiopian hospitals.
Method: We searched MEDLINE, Embase, Scopus, Web of Science from inception to 4 May 2025, and also searched Google Scholar and manually reviewed the reference lists of eligible studies. Primary studies conducted in Ethiopian hospitals that reported on the appropriateness of inpatient antibiotic prescribing were included. Two authors independently screened studies and extracted data. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools. Because of the heterogeneity in study population, definitions and outcome measures, findings were synthesised descriptively. The review was registered in PROSPERO (CRD420251051881).
Results: Fifty-three studies were included from seven Ethiopian regions, most from Amhara (n = 16). Overall, study quality was variable, with common limitations including unclear sampling and incomplete methodological reporting. Most studies focused on adult patients (n = 24) and used the Ethiopian Standard…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 45 participants or records.
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