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Kidu Gidey, Solomon Girmay Aregawi, Berhane Yohannes Hailu, Solomon Weldegebreal Asgedom, Yirga Legesse Niriayo Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, EthiopiaCorrespondence: Kidu Gidey, Email kidu.gidey@mu.edu.etIntroduction: Antimicrobials are among the most commonly misused medications, leading to antimicrobial resistance, and therefore demand more attention. There are limited studies documenting “antimicrobial use-related problems” in developing countries, especially in pediatric patients.Objectives: This study aimed to evaluate the prevalence of antimicrobial use-related problems and risk factors among hospitalized pediatric patients.Materials and Methods: A hospital-based prospective observational study was conducted in Ayder comprehensive specialized hospital (ACSH) in the Tigray region, Ethiopia. The participants of the study were pediatric patients aged ≤ 15 years who were admitted with a diagnosis of infectious disease between September 2019 and November 2019.Results: A total of 232 pediatric patients were included in the study. Of these, 59.5% of the patients were male and the mean age (SD) of the patients was 5.8 (5.2) years. Of the 232 patients surveyed, a total of 177 antimicrobial use-related problems were identified. One or more antimicrobial use-related problems have occurred in more than half of the patients (53.9%). The commonest antimicrobial use problems were unnecessary antimicrobial therapy (22.8%) followed by need additional antimicrobial therapy (16.4%). In a multivariate logistic regression model, patients with comorbidities (Adjusted odds ratio (AOR): 1.84, 95% confidence interval (CI): 1.04– 3.27) and hospital stays exceeding one week (AOR=1.88, 95% CI: 1.08– 3.26) were predictors of antimicrobial use-related problems.Conclusion: Antimicrobial use-related problems were found in a significant proportion of pediatric patients. Addressing these issues necessitates collaborative efforts, emphasizing targeted education, strengthened antimicrobial stewardship, ensuring responsible antimicrobial use and enhancing pediatric care.Keywords: antimicrobial use-related problems, pediatric, Ethiopia

Kidu Gidey, Abadi Mache, Berhane Yohannes Hailu, Solomon Weldegebreal Asgedom, Segen Gebremeskel Tassew, Yirga Legesse Nirayo Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, EthiopiaCorrespondence: Kidu Gidey, Email kidu.gidey@mu.edu.etIntroduction: Ethiopia has one of the highest HIV burdens in sub-Saharan Africa. Despite the fact that second-line antiretroviral therapy (ART) has been available for more than ten years, studies on its effectiveness are scarce.Objective: To assess treatment outcomes and predictors of unfavorable outcomes in HIV patients receiving second-line ART at Ayder Comprehensive Specialized Hospital and Mekelle Hospital.Materials and Methods: An institution-based retrospective cohort study was conducted in two hospitals in Tigray Region, Ethiopia. We evaluated 192 patients aged ≥ 15 years who were switched to second-line from November 2009 to May 2020 after failure of first-line ART. The primary outcome was the time from the initiation of second-line ART to the occurrence of unfavorable treatment outcomes (treatment failure, death, and loss to follow-up). We performed Kaplan–Meier survival estimates to calculate the cumulative incidence rates of unfavorable outcomes.Results: The mean age (SD) at the initiation of second-line ART was 39 (10.03) years, and the median CD4 cell count was 121 cells/microL. During a median follow-up of 4.6 years, 24 (12.5%) patients had died, 11 (5.7%) patients were lost to follow up, and 47 (24,4%) patients were experienced treatment failure. The incidence rates for unfavorable outcomes were 7.8 per 100 patients/years. Predictors for unfavorable outcomes were body mass index (BMI) < 18.5 (adjusted hazard ratio [aHR] = 2.51, 95% confidence interval (CI): 1.27– 4.95) and CD4 counts ≤ 100 cells/microL (aHR = 1.74, 95% CI: 1.09– 2.79). Despite the failure of second-line ART, none of the patients received third-line ART.Conclusion: The incidence rate of unfavorable treatment outcomes for second-line ART was found to be high. A low BMI and a low baseline CD4 count were significant predictors of unfavourable outcomes and should be given special consideration in HIV care. A third-line ART regimen should also be considered for people who have failed second-line ART.Keywords: human immunodeficiency virus, second-line ART, outcomes