Rational Use of Antimicrobials in the Management of Community Acquired Pneumonia at Ndola Teaching Hospital

Background: Community-acquired pneumonia (CAP) is a significant lower respiratory tract infection that poses challenges in treatment due to rising antimicrobial resistance (AMR). Rational antibiotic use is crucial for effective management and reducing the risk of resistant pathogens. This study aims to assess the rational use of antibiotics in treating CAP at Ndola Teaching Hospital (NTH) and evaluate adherence to established guidelines. By examining prescribing practices, the study seeks to identify gaps and inform best practices that enhance antibiotic stewardship. Ultimately, the findings will contribute to improving patient outcomes and guiding antibiotic prescriptions in similar healthcare settings in Zambia. Objective: To assess the rational use of antibiotics in the management of community acquired pneumonia at Ndola Teaching Hospital. Methodology: This was a mixed-method study that assessed the rational use of antibiotics in managing CAP at NTH. Data was collected and analysed using IBM SPSS Statistics version 26, employing Chi-square tests and logistic regression to identify factors influencing in-hospital mortality. Results: Out of 142 patient files reviewed, most patients were female (61.3%) and under 65 years old (69.0%), with ceftriaxone being the most prescribed antibiotic. Significant factors influencing in-hospital mortality included age over 65, length of hospital stay, allergies, co-morbidities, and management inconsistent with the 2020 national Standard Treatment Guidelines (p < 0.000). Multivariable logistic regression revealed that older age (aOR: 0.295, CI: 0.173-0.418, p < 0.000) and Length of hospital stay (aOR: 0.118, CI: 0.058-0.178, p < 0.000) significantly increased mortality risk. Additionally, 41.2% of prescribers had not seen the guidelines, highlighting the need for better dissemination and improved resources for effective CAP management at NTH. Conclusion: This study emphasized the importance of improved adherence to national treatment guidelines. The implementation of educational interventions and the promotion of collaboration among healthcare professionals are essential to optimizing antibiotic use in the management of CAP, which could lead to reduced mortality rates and improved patient outcomes.