Antibiotic prescribing patterns for sore throat infections in a university-based primary care clinic

Abstract

BACKGROUNDRecent studies reveal that a high percentage (over 50%) of episodes for URTIs are treated with antibiotics, regardless of appropriateness or the necessity for prescription. We identified antibiotic prescriptions in a primary health care centre (PHC) and evaluated their suitability for sore throat infections. We also to explored whether symptoms, signs, diagnosis and antibiotics prescribed differed by gender.PATIENTS AND METHODSWe collected data on all patients visiting the centre over a period of 12 weeks with a main complaint of sore throat who were prescribed antibiotics after taking a blood count and throat culture. Patients older than 16 years of age were included in the study irrespective of sex, nationality, marital status, occupation or location of residence. The chi square (χ2) statistical test was used in comparing categorical variables. A P value of <0.05 was considered significant.RESULTSDuring the period of study, 579 patients with upper respiratory tract infections (URTIs) presented to the health centre, from which 339 patients with a sore throat were enrolled. Of the study group, 48.7% (165) were male and 51.3% (174) female, with the majority of patients being under 30 years old (54.3%). Throat cultures were positive in 56 patients (16.5%). Most of patients were diagnosed as having pharyngitis (22.7%), and the most frequently prescribed medicine was an oral penicillin (39.1%). Two hundred eight-six patients (84.4%) had 2 or fewer Centor criteria.CONCLUSIONSThroat cultures were positive in only 16.5% of the patients prescribed antibiotics. This indicates that physicians in the health centre of the university are prescribing antibiotics inappropriately and inconsistently. This also highlights the need for more prescriber education, especially as the range of medications available to the general practitioner for prescribing increases.

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“…It is quite high considering viral etiology of most of the cases of ARIs and is higher than reported by Senok et al, (52%) and Ayranci et al, (60%) in their studies 15,16 . This excessive and in appropriate use of antibiotics has been a major contributor to the evergrowing problem of antibiotic resistance.…”

Prescription practice in patients of upper respiratory tract infection at a pediatric outpatient clinic in Punjab

“…al. 16,17 This is a reflection of the critical decision in medical care while prescribing the antibiotics for URTI. In present study, macrolides were the most commonly prescribed antibiotic followed by Penicillin (31% & 65%).…”

Validity and reliability of instruments designed to measure factors influencing the overuse of antibiotics

“…Some studies used qualitative methods, such as interviews [36,[43][44][45] or focus group discussions [37,40]. However, the development and validation of instruments measuring the overuse of antibiotics at the physician level were not mentioned in a number of the studies reviewed [40,46,47]. This result indicates the need to develop a valid and reliable instrument to measure the factors leading to the overuse of antibiotics associated with doctors.…”

“…Most studies used self-administered questionnaires either mailed [41,42,48] or handed to doctors [46,47,49]. [48] used an instrument previously developed by the United States Centers for Disease Control and Prevention (CDC).…”