by Caleb Sooknanan
In primary health care settings, antibiotics are among the most expensive and widely used therapeutic drugs. The usage of antibiotics is typically regulated so that it is of appropriate dosage and affordability for a patient. A recent study performed by Dr. Shafinaz Shamsuddin and his team of researchers from Universiti Teknologi in Malaysia evaluated the use of antibiotics for acute infections in the Selangor State’s primary health clinics. The researchers also aimed to understand drug use and procurement patterns in these environments.
The study surveyed 735 randomly selected patients from primary health clinics who had received antibiotic treatment during 2013 year. Data, including the names and dosages of the antibiotic, were collected from each patient. Malaysia’s antibiotic guidelines were used to determine whether each fell within the recommended threshold.
While the study investigated multiple antibiotics, amoxicillin was the most prescribed. Doses were more dependent on local trends and clinical diagnosis than either the national or international dose systems. Despite guidelines stating that it is more appropriate for other conditions, such as rhinosinusitis, amoxicillin was mainly used to treat respiratory infections. Also, the study showed that 18.4% of patients with an upper respiratory tract infection were inappropriately given amoxicillin instead of phenoxypenicillin.
Currently, physicians worry about poor outcomes, thereby prescribing drugs excessively or incorrectly to obtain desired results. In addition, patients may demand access to antibiotics to alleviate illnesses with viral etiologies, even when they are unnecessary.
Based on the study’s results, the researchers suggested that measures must be taken to more closely control antibiotic prescriptions. For example, stronger communication between pharmacists and physicians could ensure that prescription guidelines are met. Educating patients would also increase their awareness of prescription guidelines and the proper treatments for their illnesses.
With the increasing potential of antibiotics, understanding the factors influencing their prescription highly important. More research is needed to better understand the inconsistencies in physicians’ choices of antibiotics. Given the local nature of this study, further investigation could also be done in other clinics in the area to increase the understanding of prescription patterns.
- S. Shamsuddin, et al., Antimicrobial drug use in primary healthcare clinics: a retrospective evaluation. International Journal of Infectious Diseases 52, 16-22 (2016). doi: 10.1016/j.ijid.2016.09.013
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