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The aim of this study was to assess the extent of poly-pharmacy, occurrence, and associated factors for the occurrence of drug–drug interaction (DDI) and potential adverse drug reaction (ADR) in Gondar University Teaching Referral Hospital. Institutional-based retrospective cross-sectional study. This study was conducted on prescriptions of both in and out-patients for a period of 3 months at Gondar University Hospital. Both bivariate analysis and multivariate logistic regression were used to identify risk factors for the occurrence of DDI and possible ADRs. All the statistical calculations were performed using SPSS® software. A total of 12,334 prescriptions were dispensed during the study period of which, 2,180 prescriptions were containing two or more drugs per prescription. A total of 21,210 drugs were prescribed and the average number of drugs per prescription was 1.72. Occurrences of DDI of all categories (Major, Moderate, and Minor) were analyzed and DDI were detected in 711 (32.6%) prescriptions. Sex was not found to be a risk factor for the occurrence of DDI and ADR, while age and number of medications per prescription were found to be significant risk factors for the occurrence of DDI and ADR. The mean number of drugs per prescription was 1.72 and hence with regard to the WHO limit of drugs per prescription, Gondar hospital was able to maintain the limit and prescriptions containing multiple drugs supposed to be taken systemically. Numbers of drugs per prescription as well as older age were found to be predisposing factors for the occurrence of DDI and potential ADRs while sex was not a risk factor.

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The overall rate of bleeding in this cohort was low relative to similar observational studies. The rate of major bleeding was higher in patients prescribed warfarin compared to DOACs, with a similar rate of major bleeding for DOACs and antiplatelet agents. Our findings suggest potential to strategies to reduce bleeding include using DOACs in preference to warfarin, and avoiding multiple antithrombotic therapies in patients with AF.

Methods: Prospective follow-up study design was used to assess antimicrobial utilization pattern of patients in internal medicine wards. Patients admitted in four internal medicine wards were followed prospectively over a month and a half. Main Outcome Measures: WHO/INRUD hospital and patient care indicators for the use of antimicrobials were utilized to measure rational drug use. Descriptive and analytical statistics were done using SPSS version 19. Results: A total of 142 patients were admitted in four wards during the study period. Of these, 85(59.8%) were initiated on one or more antimicrobials in their treatment regimen. Over the course Original Research Articleof the study, a total of 238 patient antimicrobials were prescribed, of which 42% were intravenous. Average number of antimicrobials per hospitalization was found to be 2.8±1.4. Pneumonia was the most frequent diagnosis and Cephalosporin, notably Ceftriaxone was the most frequently prescribed medication. From total diagnoses undertaken, 45.8% were treated in-line with the national standard treatment guideline. Median duration of total antimicrobial course was 13 days, while the average hospital stays of patients were 17 days. Conclusion: Higher consumption of antimicrobials and conspicuously broad-spectrum antibiotics was observed during the study period. Most of the antimicrobials were prescribed empirically rather than waiting laboratory diagnosis for definitive therapy. Utilization pattern of antimicrobials was, mostly not in concordance with the national standard treatment guideline. Hence, there is a need for further large scale study on the utilization pattern of antimicrobials nationwide and antimicrobial stewardship in Gondar University Hospital.