Assistant Professor Prince Sattam bin Abdulaziz University, Saudi Arabia
Background: Medication errors (MEs) impose a substantial burden on healthcare systems and have been linked to considerable morbidity and mortality. Medical literature has extensively documented MEs but has been deficient in scrutinizing medications with high-risk profiles, such as antimicrobials.
Objectives:
Objectives: This study aims to identify the types, trends, and patterns of the reported antimicrobial errors in the Eastern region’s medical centers in Saudi Arabia.
Methods: This is a cross-sectional retrospective analysis of the MEs reporting databases of the Ministry of Health-affiliated hospitals in Saudi Arabia between January 1 and December 31, 2019. Descriptive analysis was used to determine the most frequent antimicrobials with errors, the stage of antimicrobial errors, the types of errors, the contributing factors to the errors, and the categories of errors as per the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification of errors. Additionally, a multivariable negative binomial model was applied to predict the error count as the dependent variable, considering hospital size (classified as small, medium, or large), urban versus rural location, and general versus specialized setting as explanatory variables.
Results: A total of 1422 antimicrobial errors, equating to (22.1%) of all 6,412 MEs were recorded in the database. The most frequently reported antimicrobial was Amoxicillin/Clavulanate, accounting for 18%. Most of the errors occurred during the prescription stage, accounting for 87.6%, and were primarily due to incorrect dosing (32.1%) and duplicate treatment (20.5%). Additionally, most of these errors were classified as category B (72.5%), and the most frequently cited factor was inexperience among personnel (57.9%) and lack of policies (48.3%). The negative binomial model showed that small hospital settings had a rate ratio of 0.13 (95% CI, 0.02 to 0.90, P=0.039), but none of the other variables were statistically significant.
Conclusions: The study results indicated that antimicrobial errors predominantly take place during the prescription phase and are the result of policy deficiencies and a lack of experience among staff. To enhance appropriate use of antimicrobials and address these errors, it is recommended to prioritize education for prescribers, establish clear dosing rules, and establish antimicrobial stewardship initiatives.
