Pattern and determinants of antibiotic mal-prescribing among family physicians in the primary health care facilities in Iran

Abstract

Background Mal-prescribing of antibiotics is a major and ongoing global public health problem both in developing and developed countries. Family physicians are the most important and dominant health services providers in Iran that pattern describing by them poorly understood. This study aimed to assess the pattern and factors affecting antibiotic prescribing by family physicians in primary health care (PHC).Methods In this descriptive-analytical study, 1068 prescriptions of family physicians in PHC were assessed among Alborz province health facilities. Prescriptions were selected by random sampling. The mal-prescribing was assessed based on 4 criteria including dose per consumption, dose per day, correct duration of therapy and possible interaction with other antibiotics. Logistic regression was used to estimate the odds ratio and 95% confidence interval for the association between antibiotic prescribing and affecting factors.Results The average number of antibiotics was reported 1.27 per prescription and almost 56.8% of them had at least an antibiotic. There was a statistically significant relationship between age, gender, type of insurance booklet, work experience of physicians, seasons of the year and receiving antibiotics (P<0.05). In 59.31% of antibiotic prescriptions at least one of the scientific criteria was not satisfied.Conclusion The number of prescribed antibiotics and the mal-prescribing percentage were high among family physicians. Strong political commitment and altering physicians' training curricula especially promoting a preventive approach and developing a registration system for identifying adverse drug reactions, antibiotic use patterns and mal-prescribing are imperative at the grass-root level.