Antibiotic prescribing for acute respiratory infections in children in Jordan

Ababneh, Mera A.; Al‐Azzam, Sayer; Ababneh, Rawan Abid Alkareem; Rababa’h, Abeer; Demour, Saddam Al

doi:10.1093/inthealth/ihx003

Cited by 27 publications

(31 citation statements)

References 23 publications

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“…This result may attributed to low pharmaceutical care interventions, physicians poor adherence to the guidelines, and absence of clinical decision support system in the operated computerized physician order entry system (CPOE) . Our findings are in line with other studies in Jordan that indicated high rate of DDIs and poor adherence to the guidelines by physicians (21,22,27). The difference between the recent studies in Jordan and our study is that the patient group in our research is highly vulnerable to severe deadly complications, and thus urgent precautionary measures are necessary.…”

Section: Discussionsupporting

confidence: 89%

“…However, a recent study indicated that CKD is highly underdiagnosed in Jordan (19). Physicians in Jordan demonstrated poor adherence to current practice guidelines for safe prescription of antibiotics (20)(21)(22)(23), proton pump inhibitors (24,25), and non-steroidal antiinflammatory drugs (26). In addition, high rate of major and moderate drug-drug interactions was found among elderly patients in Jordan (27).…”

Section: Introductionmentioning

confidence: 99%

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Drugs-Induced QT Interval Prolongation among End-Stage Renal Disease Patients in Jordan

Naser

2020

Preprint

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Background In spite of high risk of mortality due to drug-induced QT interval prolongation (QTcP) usage among end stage renal disease patients (ESRD), no previous studies were conducted to assess medication safety of this drugs category among this vulnerable patients group. Objectives This study aimed to investigate the appropriateness and potential drug-drug interactions of QTcP-inducing drugs among ESRD patients in Jordan. Method This study was a cross-sectional retrospective study conducted in the outpatient clinics of 200 Jordanian healthcare facilities over three years (2017, 2018, and 2019) using Hakeem© database for data collection. CredibleMeds© was used to identify and categorise QTcP-inducing drugs. Drug-drug interactions and appropriateness of prescribing were assessed by Micromedex Drug Reax© software and a multidisciplinary committee, respectively. Results Of the 407 patients included, 954 drugs with risk of QTcP were dispensed; 618 (64.8%) had interactions with other drugs; 10.4% were major, 29.3% were moderate, and 60.3% were minor drug-drug interactions. Absence of major polypharmacy and co-morbidity decreased the odds of major drug-drug interactions by 61% (OR 0.61; 95% CI 0.23-0.97; p=0.02), and 72% (OR 0.72; 95% CI 0.44-1.23; p=0.04), respectively. After clinical evaluation, 17.6% of the dispensed drugs were considered inappropriate application, 12.9% were classified as inappropriate choice, and 26.4% were judged as inappropriate decision. Urology clinics were more likely to prescribe QTcP-inducing drugs based on inappropriate decision. Conclusion Major drug-drug interactions and dispensing medications with risk of QTcP based on inappropriate prescribing decisions for patients with ESRD were reported to be high in outpatient clinics in Jordan.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Drugs-Induced QT Interval Prolongation among End-Stage Renal Disease Patients in Jordan

Naser

2020

Preprint

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“…Most antibiotic prescriptions are provided in outpatient care, with respiratory tract infections being the most common diagnoses 3. Studies have shown that up to 78% of patients are prescribed antibiotics for respiratory tract infections in primary care, even though an estimated 90% are viral in aetiology and thus antibiotics are seldom required 4–8. Indeed, unless pneumonia is suspected, the effect of antibiotic treatment is moderate at best indicating that many antibiotic prescriptions are provided unnecessarily and without any overall patient benefit 9.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with antibiotic prescribing in patients with acute respiratory tract complaints in Malta: a 1-year repeated cross-sectional surveillance study

et al. 2019

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ObjectiveTo identify factors that influence general practitioners’ (GPs’) oral antibiotic prescribing for acute respiratory tract complaints (aRTCs) in Malta.DesignRepeated, cross-sectional surveillance.SettingMaltese general practice; both public health centres and private GP clinics.Participants30 GPs registered on the Malta Medical Council’s Specialist Register and 3 GP trainees registered data of 4831 patients of all ages suffering from any aRTC. Data were collected monthly between May 2015 and April 2016 during predetermined 1-week periods.Outcome measuresThe outcome of interest was antibiotic prescription (yes/no), defined as an oral antibiotic prescription issued for an aRTC during an in-person consultation, irrespective of the number of antibiotics given. The association between GP, practice and consultation-level factors, patient sociodemographic factors and patient health status factors, and antibiotic prescription was investigated.ResultsThe antibiotic prescription rate was 45.0%. Independent factors positively associated with antibiotic prescribing included female GP sex (OR 2.3, 95% CI 1.22 to 4.26), GP age with GPs ≥60 being the most likely (OR 34.7, 95% CI 14.14 to 84.98), patient age with patients ≥65 being the most likely (OR 2.3, 95% CI 1.71 to 3.18), number of signs and/or symptoms with patients having ≥4 being the most likely (OR 9.6, 95% CI 5.78 to 15.99), fever (OR 2.6, 95% CI 2.08 to 3.26), productive cough (OR 1.3, 95% CI 1.03 to 1.61), otalgia (OR 1.3, 95% CI 1.01 to 1.76), tender cervical nodes (OR 2.2, 95% CI 1.57 to 3.05), regular clients (OR 1.3, 95% CI 1.05 to 1.66), antibiotic requests (OR 4.8, 95% CI 2.52 to 8.99) and smoking (OR 1.4, 95% CI 1.13 to 1.71). Conversely, patients with non-productive cough (OR 0.3, 95% CI 0.26 to 0.41), sore throat (OR 0.6, 95% CI 0.53 to 0.78), rhinorrhoea (OR 0.3, 95% CI 0.23 to 0.36) or dyspnoea (OR 0.6, 95% CI 0.41 to 0.83) were less likely to receive an antibiotic prescription.ConclusionAntibiotic prescribing for aRTCs was high and influenced by a number of factors. Potentially inappropriate prescribing in primary care can be addressed through multifaceted interventions addressing modifiable factors associated with prescription.Trial registration number NCT03218930

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“…параты в педиатрии, и большая часть назначений прихо-дится именно на ОРВИ (78,4%), что под собой не имеет никакой основы [5,6].…”

Section: бронхопульмонология и лорunclassified

“…При этом необоснованная антибактериальная нагруз-ка приходится достоверно чаще на детей до 5 лет, в основном с ОСО и ОТ, в отличие от пациентов с лихорад-кой и более старшего возраста (6-12 лет) [5,7].…”

Section: бронхопульмонология и лорunclassified