Quality Indicators of Antimicrobials Prescribing in Iraq: A Scoping Review

Abstract

Background: Antimicrobial overconsumption is a global public health concern, particularly in the Middle East, where illnesses and antibiotic use are on the increase. Antimicrobial resistance is associated with excessive usage. As a Middle Eastern country, Iraq provides a suitable baseline for situating it amid its neighbors. We use quality indicators to reliably identify bad practice and recommend updated antibiotic prescribing practices for hospitalized patients. Objectives: To compare antimicrobial prescribing quality metrics in Iraqi hospitals to those in Middle Eastern nations. Methods: We conducted a literature review using a point prevalence survey to assess the inappropriateness of antimicrobial usage in hospitals in the Middle East countries after evaluating literature from sources such as Scopus, Web of Science, PubMed, and EBSCO. To examine the Iraqi scenario, we used four primary quality indicators: guidelines compliance, stop/review note documentation, parenteral administration, and the selection of targeted antibios. Results: According to the study, Iraq's guideline availability ranged from 0% to 7%, which was lower than Jordan's optimum of 95.8%. The rate of stop/review documentation was approximately 0.4%, which was lower than the maximum rate of 72% in the UAE; and only 1.2% of prescriptions were targeted antibiotics, which was higher than Iran's 0%. Regarding parenteral antibiotics, Iraq reported that 89.9% of the antibiotics used were injectable, which is consistent with most comparable nations (74%-100%). Conclusions: In Iraqi hospitals, antimicrobials are used inappropriately. An immediate effort is necessary to update national records, with ongoing follow-up by regular prevalence surveys.