Inappropriate antibiotic utilization in hospitalized patients in Ethiopia: A systematic review and meta-analysis
Abstract
Background: Inappropriate antibiotic use is a major driver of antimicrobial resistance and adverse clinical outcomes. Evidence on its pooled prevalence and determinants among hospitalized patients in Ethiopia remains scarce. Therefore, this study aimed to estimate the pooled prevalence of inappropriate antibiotic use and associated factors among hospitalized patients in Ethiopia.
Methods: This systematic review and meta-analysis was reported in accordance with the PRISMA statement and registered in PROSPERO (CRD420261379594). A comprehensive literature search was conducted from December 5 and December 19, 2025. Electronic databases including PubMed/MEDLINE, Embase, ScienceDirect, Scopus, and PsycINFO were systematically searched. In addition, supplementary platforms and grey literature sources including Google Scholar, ResearchGate, and HINARI were explored to identify relevant studies. Data were extracted using Microsoft Excel and analyzed using Stata version 14.0. A random-effects model was employed to estimate the pooled prevalence, and heterogeneity was assessed using the I2 statistic. Subgroup analysis, sensitivity analysis, and assessment of publication bias were also performed.
Results: Twelve primary studies were included. The pooled prevalence of inappropriate antibiotic use among hospitalized patients in Ethiopia was estimated at 40.50% (95% CI: 24.88-56.16). However, this estimate should be interpreted with caution due to the very high heterogeneity observed…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, 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.
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