Factors Influencing Antibiotic Prescription Practices for Pneumonia among Clinicians at Mbagathi Level 5 Hospital, Kenya

Although clinicians understand the importance of stewardship, inappropriate prescription of antibiotics persists in low-resource settings. This study sought to assess the factors influencing compliance for pneumonia antibiotic prescription among clinicians by focusing on the level of compliance to guidelines, socioeconomic, and health system related determinants. The study adopted cross-sectional survey design, targeting all the 171 clinicians at Mbagathi Level 5 Hospital. A census was conducted using a structured questionnaire between March 2024 and May 2024. Both descriptive and inferential statistics, including frequencies, percentages, and chi-square tests were used in analyzing data. 152 questionnaires were filled and returned, giving a response rate of 89%. Majority of the respondents were medical officers (43.4%) followed by clinical officers (36.2%) and consultants (20.4%) respectively. The findings established a moderately high compliance (68.4%) to pneumonia antibiotic prescription among clinicians. The findings also revealed significant associations between gender (c2 = 8.05, p =0.005), designation (p =0.005), presence of medical insurance (p =0.005), availability of diagnostic tests (c2 = 9.13, p =0.010), availability of drugs (c2 = 8.96, p =0.011), presence of staff (c2 = 9.514, p =0.009), knowledge and awareness (c2 = 34.42, p<0.001), and compliance to pneumonia antibiotic prescription practices among clinicians. These results affirm that health system factors such as staffing, availability of antibiotics and availability of diagnostic facilities influenced antibiotic prescription practices. Gender, designation as well as presence of medical insurance were determinants of antibiotic prescription practices. Therefore, National and County governments should focus on strengthening critical pillars of healthcare; namely; health workforce, service delivery, and medicines and vaccines in order to enhance compliance to antibiotic prescription guidelines. The influence of knowledge and awareness of antibiotic prescription guidelines underscored the need for health facilities to invest in continuous training on antibiotic stewardship