Determinants of antibiotic prescribing among doctors in a Nigerian urban tertiary hospital

Ogunleye, Olayinka O; Fadare, Joseph; Yinka-Ogunleye, Adesola; Paramadhas, Bene D. Anand; Godman, Brian

doi:10.1080/21548331.2018.1475997

Cited by 54 publications

(51 citation statements)

References 42 publications

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“…Overall, the extensive use of broad-spectrum antibiotics in Pakistan could be explained by high bacterial resistance rates [71], and the potential for practitioners to overprescribe antibiotics if they view such practices as a viable way to ensure a speedy recovery [72,73]. Additionally, physicians in Pakistan may be influenced by pharmaceutical companies if they are the principal source of information as seen in other settings in Pakistan and other countries [21,[74][75][76].…”

Section: Discussionmentioning

confidence: 99%

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

Saleem

Hassali

Versporten

et al. 2019

Expert Review of Anti-infective Therapy

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Objective:In line with the recent global action plan for antimicrobial resistance, the first time such a comprehensive survey has been undertaken in Pakistan, sixth most populous country. Method:This point prevalence survey (PPS) was conducted in 13 hospitals among 7 different cities of Pakistan. The survey included all inpatients receiving an antibiotic on the day of PPS. A web-based application was used for data entry, validation, and reporting as designed by the University of Antwerp. Results:Out of 1954 patients, 1516 (77.6%) were treated with antibiotics. Top three most reported indications for antibiotic use were prophylaxis for obstetrics or gynaecological indications (16.5%) and gastrointestinal indications (12.6%) and lower respiratory tract infections (12.0%). Top three most commonly prescribed antibiotics were ceftriaxone (35.0%), metronidazole (16.0%) and ciprofloxacin (6.0%). Out of total indications, 34.2% of antibiotics were prescribed for community-acquired infections (CAI), 5.9% for healthcare-associated infections (HAI), and 57.4% for either surgical or medical prophylaxis. Of total surgical prophylaxis, 97.4% of antibiotics were given for more than one day. Conclusion:Study concluded that unnecessary prophylactic antibiotic use is extremely high and broad-spectrum prescribing is common. There is a considerable need to work on a national action plan of Pakistan on antibiotic resistance.

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Section: Discussionmentioning

confidence: 99%

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

Saleem

Hassali

Versporten

et al. 2019

Expert Review of Anti-infective Therapy

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“…Addressing the reasons behind the lack of funding for their dissemination, including how technology can assist with their wider dissemination and usability in practice to promote RUM, should be explored further. This is particularly important in situations where physician education is principally offered via pharmaceutical companies with the potential for bias (Spurling et al, 2010;Riaz et al, 2015;Fickweiler et al, 2017;Khazzaka, 2019;Ogunleye et al, 2019), although ethical codes of practice are increasing across countries to address such concerns (Francer et al, 2014). As a result, there might be a need in some countries to develop a better understanding of mechanisms to ensure continuous updating and dissemination of clinical guidance as well as continual professional development around clinical pharmacology and RUM.…”

Section: Discussionmentioning

confidence: 99%

Mapping of Current Obstacles for Rationalizing Use of Medicines (CORUM) in Europe: Current Situation and Potential Solutions

Gad

Salem²,

Oortwijn

et al. 2020

Front. Pharmacol.

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“…Rural and township healthcare doctors in China work in a di cult situation in which microbiological tests are unavailable and it is hard to tell the pathogen and its sensitivity to speci c antibiotics from clinical symptoms/history. So they tend to view broad spectrum or combined antibiotics as a safer strategy than narrow spectrum antibiotics since the former have greater chance of hitting the actual pathogen [27] .…”

Section: Determinants Of Antibiotics Use and Bacteria Identi Cationmentioning

confidence: 99%

Clinical symptoms and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship

Shen

Pan

et al. 2020

Preprint

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Background This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural Anhui Province and implications for future antibiotic stewardship. Methods The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews in village clinics and township health centers were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing. Results A total of 1068 (51.0% males and 49.0% females) completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR = 1.91), season (OR = 0.41 to 0.60), days since infection onset (OR = 1.54 to 1.81), and runny or blocked nose (OR = 1.39 to 1.61), cough with green or white sputum (OR = 1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR = 0.53) and sore throat (OR = 1.64). Conclusions The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by patient reassurance and other non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.

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Determinants of antibiotic prescribing among doctors in a Nigerian urban tertiary hospital

Abstract: There is an urgent need to institute evidence-based institutional policies and guidelines for improving antimicrobial use among hospitals in Nigeria. This is already being followed up.

Cited by 54 publications

References 42 publications

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

Mapping of Current Obstacles for Rationalizing Use of Medicines (CORUM) in Europe: Current Situation and Potential Solutions

Clinical symptoms and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship

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