Antibiotic Prescription Practices in Ophthalmology Outpatient Clinics in Khartoum, Sudan: An Observational Cross-Sectional Study

Background: Antimicrobial resistance is a growing global health concern, posing serious threats to the population's health and well-being. However, the situation in Sudan is unknown. This study explores antibiotic prescriptions in ophthalmology outpatient clinics in Khartoum. Methods: This descriptive cross-sectional study was conducted from January to April 2023 across major ophthalmology teaching hospitals in Khartoum. Data were collected using a validated, pretested, anonymous online questionnaire capturing demographic information and responses to five guideline-based clinical vignettes. Analysis was performed via SPSS Version 27 (IBM Corp., Armonk, NY, USA). Results: Of the 215 participants, 64.7% (n=139) were prescribed using brand names, and only 12.6% (n=27) of them had attended a course on prudent antibiotic prescription. Scientific articles or guidelines were the primary sources for practice for 62.8% (n=135) of the total participants; yet, residents mainly depended on asking a senior colleague (42%, n=55). Regarding case-related practice questions, most of the participants complied with the guidelines for grade two hyphema (63.3%, n=136), subconjunctival hemorrhage (80.9%, n=174), and preoperative preparation for cataract surgery (63.7%, n=137). For acute postoperative endophthalmitis, 68.8% (n=148) of the participants used intravitreal antibiotic injections. However, there was no specific preference for certain antibiotics in the case of corneal abrasion. Conclusion: The practice of antibiotic prescription in this study varied among respondents and from the literature. It also highlighted the impact of the work environment on prescription practice, which might be attributable to the deficiency of a unified source of evidence and practice nationally. Therefore, the development of national ophthalmic antibiotic guidelines, structured training, and periodic audits would improve practice patterns.