Assessment of Rational Use of Injection Therapy in Medical Wards of Secondary Hospitals in Ebonyi State, South East Nigeria

Background: Overuse of injectable medications, compared to equally effective oral alternatives, contributes to increased healthcare costs, infection risks, and patient discomfort. Monitoring the rational use of injection therapy is a key WHO drug use indicator. This study assessed the rational use of injection therapy in medical wards of secondary hospitals in Ebonyi State. Methods: A cross-sectional retrospective study reviewed 480 inpatient prescription records from the medical wards of four secondary hospitals across three senatorial zones of Ebonyi State. The percentage of encounters with at least one injectable, injection-to-oral switching patterns, and justification for injection use were assessed against current treatment guidelines. Results: Injectable medications were present in 74 percent of reviewed prescriptions. Oral alternatives existed for 48 percent of prescribed injectables. Documented clinical justification for injection use was present in only 31 percent of cases. Intravenous antibiotics were switched to oral within 72 hours in just 22 percent of clinically appropriate cases. Conclusion: Injection overuse is prevalent in Ebonyi State secondary hospitals. Prescriber education on injection therapy appropriateness and implementation of intravenous-to-oral switch protocols are priority interventions. Keywords: injection therapy, rational drug use, Ebonyi State, intravenous-to-oral switch, prescribing