Antimicrobial drug use in primary healthcare clinics: a retrospective evaluation
Objectives: To examine the appropriateness of antibiotics prescribed for acute infection based on the Malaysian national antibiotic guidelines and the defined daily dose (DDD) system of the World Health Organization (WHO). This study also aimed to describe the factors influencing the drug use patt...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English English |
| Published: |
2016
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/52704/ http://irep.iium.edu.my/52704/ http://irep.iium.edu.my/52704/ http://irep.iium.edu.my/52704/1/Antimicrobial%20drug%20use%20in%20primary%20healthcare%20clinics.pdf http://irep.iium.edu.my/52704/7/52704-Antimicrobial%20drug%20use%20in%20primary%20healthcare%20clinics_SCOPUS.pdf |
| Summary: | Objectives: To examine the appropriateness of antibiotics prescribed for acute infection based on the
Malaysian national antibiotic guidelines and the defined daily dose (DDD) system of the World Health
Organization (WHO). This study also aimed to describe the factors influencing the drug use pattern and
to investigate the procurement patterns of antibiotics in the primary healthcare setting.
Methods: A retrospective cohort follow-up study of randomly selected patients from all patients who
received any antibiotic between January and December 2013 was conducted at three primary healthcare
clinics in Selangor State of Malaysia. For each patient, the following information was recorded: name of
the antibiotic, frequency and dose, and Anatomical Therapeutic Chemical (ATC) group. The defined daily
dose per 1000 inhabitants per day was calculated for each antibiotic. The national antibiotic guidelines
were used to assess the appropriateness of each antibiotic prescription.
Results: A total of 735 patients were included in the study. The five most used antibiotics were
amoxicillin (1.36 g, 35.2%), cloxacillin (0.68 g, 26.3%), erythromycin (0.32 g, 22.3%), bacampicillin (0.13 g,
7.2%), and cephalexin (0.11 g, 6.9%). Respiratory tract infections were the most commonly treated
infections, and the doctors’ preferred antibiotic for the treatment of these infections was amoxicillin.
More than 18% of all amoxicillin prescriptions were deemed inappropriate according to the national
antibiotic guidelines. In terms of procurement costs, USD 88 885 was spent in 2011, USD 219 402 in
2012, and USD 233 034 in 2013 at the three primary healthcare clinics, an average of USD 180 440 per
year for the three clinics.
Conclusions: This study reports the antibiotic usage at three primary healthcare clinics in Klang Province.
The most prescribed antibiotic was amoxicillin in capsules (250 mg), which was mainly prescribed for
respiratory infections. Although the national antibiotic guidelines state that amoxicillin is a preferred
drug for acute bacterial rhinosinusitis, this drug is also being prescribed for other disease conditions,
such as acute pharyngitis and acute tonsillitis. This result shows that current practice is not following the
current antibiotic guidelines, which state that phenoxypenicillin should be the preferred drug. |
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