Background: Bacterial contamination of milk is a primary culprit for causing foodborne illnesses, presenting a significant health hazard for millions of individuals around the globe. The level and variety of microorganisms present in raw milk determine its degree of contamination and the potential health risks it poses. Methods: A cross-sectional survey was conducted from February to August. A questionnaire was used to collect data on socio-demographic characteristics and hygiene practices from milk distributors and traders. Raw milk, yoghurt, swabs from milk containers and drinking cups were collected and processed for bacterial isolation and identification, antibiotic susceptibility testing, MDR screening and confirmation, ESBL screening and confirmation. Finally, all data were pooled and analyzed using SPSS software version 25. Results: A total of 120 samples of fresh milk, yogurt and cotton swabs from milk containers and cups were collected. A total of 80 bacterial isolates were isolated from 120 samples. Among the bacteria isolated, S. aureus 17 (21.3%), E. coli 17 (21.3%), S. epidermidis 14 (17.5%), Klebsiella spp. 9 (11.3%) and Salmonella spp. 7 (8.8%) were detected most often. High rate of contamination was observed in fresh milk 23 (28.8%) and yogurt 23 (28.8%). All isolates were resistant to at least one antibiotic tested. Comparatively, high rates of resistance were observed in all isolates to the most commonly prescribed antibiotics in Ethiopia. However, lower rates of resistance have been observed for recently introduced antibiotics in Ethiopia. Of the isolates, 20 (25.0%) were resistant to eight or more antibiotics. While 16 (20.0%), 12 (15.0%), 9 (11.3%) isolates were resistant to two, three and five antibiotics, respectively. Of the bacteria isolated, 52/80 (65.0%) were MDR, 25/49 (51.0%) were screened for ESBL production, and 20/49 (40.8%) isolates were confirmed as ESBL producer. Conclusion: This study showed a high rate of bacterial isolates along with MDR and ESBL-producing strains in raw milk, yoghurt, milk container swabs and drinking cup swab samples, associated with poor hygiene and sanitation practices.

Antimicrobial resistance (AMR) is a significant public health concern worldwide. The continuous use and misuse of antimicrobial agents have led to the emergence and spread of resistant strains of bacteria, which can cause severe infections that are difficult to treat. One of the reasons for the constant development of new antimicrobial agents is the need to overcome the resistance that has developed against existing drugs. However, this approach is not sustainable in the long term, as bacteria can quickly develop resistance to new drugs as well. Additionally, the development of new drugs is costly and time-consuming, and there is no guarantee that new drugs will be effective or safe. An alternative approach to combat AMR is to focus on improving the body’s natural defenses against infections by using probiotics, prebiotics, and synbiotics, which are helpful to restore and maintain a healthy balance of bacteria in the body. Probiotics are live microorganisms that can be consumed as food or supplements to promote gut health and improve the body’s natural defenses against infections. Prebiotics are non-digestible fibers that stimulate the growth of beneficial bacteria in the gut, while synbiotics are a combination of probiotics and prebiotics that work together to improve gut health. By promoting a healthy balance of bacteria in the body, these can help to reduce the risk of infections and the need for antimicrobial agents. Additionally, these approaches are generally safe and well tolerated, and they do not contribute to the development of AMR. In conclusion, the continuous development of new antimicrobial agents is not a sustainable approach to combat AMR. Instead, alternative approaches such as probiotics, prebiotics, and synbiotics should be considered as they can help to promote a healthy balance of bacteria in the body and reduce the need for antibiotics.

The inappropriate use of surgical antimicrobial prophylaxis is a common cause for increased risk of morbidity and mortality from surgical site infection in patients who underwent surgical procedures. The study aimed to evaluate surgical antimicrobial prophylaxis prescribing patterns, Surgical Site Infection (SSI), and its determinants in the surgical ward of Debre Berhan Comprehensive Specialized Hospital, northeast Ethiopia. A prospective cross-sectional study was conducted from October 1st 2022 to January 31st, 2023. Data collected from patient medical record cards and patient interviews were entered and analyzed using SPSS V26.0. The determinants of surgical site infection were determined from the multivariable logistic regression. P-value ≤ 0.05 was considered statistically significant. Ceftriaxone (70.5%) followed by a combination of ceftriaxone with metronidazole (21.90%) was the most frequently used prophylactic antibiotic. One hundred fifty-nine (78%) of patients were exposed to inappropriately used prophylactic antimicrobials and 62.2% of these were exposed to inappropriately selected antibiotics. One hundred twenty-six (61.9%) patients developed Surgical Site Infection (SSI). Duration of procedure longer than an hour and inappropriate use of antimicrobial prophylaxiswere the independent predictors for the occurrence of surgical site infections. Patients whose operation was lasted in longer than an hour were 3.39 times more likely to develop SSI compared to those whose operation was completed in less than an hour, AOR = 3.39 (95% CI: 1.24–9.30). Similarly, controlling the effect of other covariate variables, individuals who were given inappropriate antimicrobial prophylaxis were 6.67 times more likely to develop SSI compared to those given appropriate prophylaxis, AOR = 6.67 (95% CI: 1.05–42.49). The high rate of SSI requires due attention from clinicians as well as health policymakers. Duration of surgical procedure greater than an hour and inappropriate antimicrobial prophylaxis use was the independent predictor of surgical site infections.

Background: Irrational prescribing of antibiotics leads to the emergence of resistant bacteria. Despite this fact, antimicrobial agents are commonly prescribed in the inpatient setting, especially in infants and children. Objective: The aim of this study was to assess the pattern of antibiotic prescription, appropriateness, and associated factors in pediatric wards of Tibebe Ghion Specialized Hospital (TGSH), Bahir Dar, North West Ethiopia, September 11th, 2021 to October 12th, 2021 GC (Gregorian Calendar). Methods: An institution-based cross-sectional study was conducted in the pediatric wards of TGSH from September, 2020 to August, 2021 GC. Data were collected using a structured checklist containing each patient’s socio-demographic characteristics, clinical information, list of prescribed drugs, and reason for prescription. A systematic random sampling technique was used to select pediatric patients’ medical records containing prescribed antibiotics. The collected data were entered and analyzed using SPSS version 25 software. Results: A total of 279 pediatric patients’ medical cards including at least one antibiotic were reviewed. The study revealed that antibiotics were prescribed for most of the patients (88.9%) for empiric treatment purposes. The main medical conditions for which antibiotics were prescribed were pneumonia (16.8%) and early-onset neonatal sepsis (14.0%). Ceftriaxone was the most widely used (84.9%) antibiotic among the monotherapeutic antibiotics, while ceftriaxone plus metronidazole (23.5%) was the most frequently used combination of antibiotics. A high proportion (30.8%) of the pediatric patients was exposed to inappropriate treatment. Residence in rural areas (P=0.046) and being 1 year old or younger (P< 0.05) were found to be independent determinants of inappropriate drug use. Conclusion: Antibiotics were the most prescribed class of medications for pediatric patients in TGSH. Ceftriaxone and ampicillin were the most frequently prescribed antibiotics in the pediatric wards of TGSH. A high proportion of patients had been exposed to inappropriate antibiotic treatment. Early age and rural residence were found to be the factors that were significantly associated with inappropriate antibiotic utilization.

Background: In developing countries like Ethiopia, medicines wastage becomes a major healthcare system challenge. However, data that displayed the type, extent, and contributing factors of medicines wastage were limited. Methods: A health facility-based explanatory sequential mixed study was conducted from December 2021 to February 2022. One drug and therapeutics committee (DTC) and one store man per health facility, working during the study period were included for their perception of medicines wastage and possible causes. As key informants, 1 Chief Executive Officer (CEO) and 1pharmacy head were also included per facility. In total, 80 participants were included in this study. The quantitative data to determine the magnitude of medicine wastage were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 25. Results: The overall medicines wastage in the three consecutive years was 6.3%. The trend over the three years indicated that medicines wastage is 6.5%, 5.9%, and 6.5% in 2011, 2012, and 2013 Ethiopian Fiscal Year (EFY), respectively. The medicine wastage rate has been increasing nearly by 3% between 2011/2012 and 2012/2013. The main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine’s wastage were near-expiry medicines (< 6 months) being delivered to the health facilities by suppliers, poor communication and coordination with key stakeholders, and the presence of overstocked medicines due to improper forecasting of need in the facilities. Conclusion: There is an excessive rate of medicines wastage which needs immediate mitigation by exchanging nearly expired medicines with other health facilities, communicating with suppliers and even prescribers, using auditable pharmaceutical transactions and services (APTS), providing continuous training, pursuing quality and safety medicines reuse scheme, implementation of pharmacist waste-reducing activities in all stages of the pharmaceutical supply chain, reducing medication amounts in stock, and through the use of electronic stock management tools.

Background: Ethiopians use Artemisia abyssinica and Lepidium sativum as immunity enhancers. However, there is no scientific validation conducted so far regarding this claim. The aim of this study was to investigate the in-vivo immunomodulatory activities of essential oils of A. abyssinica and L. sativum in mice. Methods: The extraction was carried out using the earlier techniques. By hydro distilling fresh seeds and aerial portions of A. abyssinica and L. sativum, respectively, essential oils were obtained. Essential oils of both plants were tested at 100, 200 and 400 mg/kg. The rate of carbon clearance, humoral antibody titer, delayed type hypersensitivity response, spleen and thymus indices were evaluated in mice according to scientific protocols. The carbon clearance assay was determined using carbon ink. Sheep red blood cell was used as an antigen for other tests. Results: Essential oils of A. abyssinica and L. sativum at 400 mg/kg significantly increased the rate of carbon clearance from the body of mice (p< 0.05). The maximum carbon clearance rate was achieved for A. byssinica essential oil at 400 mg/kg. Both essential oils raised the level of HAT to SRBC in comparison to the vehicle and cyclophosphamide administered groups. The largest (84.668± 1.951) mean secondary HAT to SRBC was generated by L. sativum essential oil at 400 mg/kg (p< 0.001). A. abyssinica essential oil at 200 and 400 mg/kg significantly increased the level of thymus index compared to the model group (p< 0.05 and 0.01 respectively). The levamisole group experienced the highest increase in thymus index (p< 0.001). Essential oil of L. sativum at 400 mg/kg also increased the level of thymus index. The spleen index in mice was improved by the essential oils only at the highest dose levels (400 mg/kg). Conclusion: It can be inferred that the essential oils of L. sativum and A. abyssinica have immunostimulant properties.