Prescribing patterns for upper respiratory tract infections: a prescription-review of primary care practice in Kedah, Malaysia, and the implications

Expert Rev Anti Infect Ther. 2015;13(12):1547-56. doi: 10.1586/14787210.2015.1085303. Epub 2015 Sep 10.

Abstract

Introduction and aims: It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among 10 public primary healthcare centers in Kedah, Malaysia, from 1 January to 31 March 2014.

Results: A total of 123,524 prescriptions were screened and analyzed. Of these, 7129 prescriptions were for URTI, with 31.8% (n = 2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic, constituting 61% (n = 1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p = 0.001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ = 0.122).

Conclusions: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programs and further educational initiatives are ongoing in Malaysia to improve antibiotic use.

Keywords: Malaysia; antibiotics stewardship programs; guidelines; inappropriate use of antibiotics; primary healthcare centres; upper respiratory tract infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Prescriptions / standards*
  • Female
  • Humans
  • Infant
  • Malaysia / epidemiology
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / standards*
  • Primary Health Care / methods
  • Primary Health Care / standards
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / epidemiology*
  • Retrospective Studies
  • Young Adult

Substances

  • Anti-Bacterial Agents