Antibiotic prescribing practices in primary and secondary health care facilities in Uttar Pradesh, India
- 1 December 2008
- journal article
- Published by Hindawi Limited in Journal of Clinical Pharmacy & Therapeutics
- Vol. 33 (6), 625-634
- https://doi.org/10.1111/j.1365-2710.2008.00960.x
Abstract
Emerging antibiotic resistance in common pathogens is a worldwide problem known to be related to inappropriate overuse of antibiotics. Wide variability in antibiotic use throughout the world is because of various factors, including socio-cultural differences. To study the rate of antibiotic prescribing for common outpatient illnesses and the various disease, patient, physician and health facility characteristics, which influence this in primary and secondary healthcare settings in Uttar Pradesh. After sampling of health facilities - both private and government, rural and urban, a cross-sectional survey of prescriptions for patients presenting with runny or blocked nose, cough, sore throat, diarrhoea or fever without localizing symptoms was conducted. Information on disease, patient, physician and facility characteristics was collected. Outcome factors: antibiotic prescription and group of antibiotic prescribed. No intervention was made. Overall antibiotic prescription rate was 81.8%. It was significantly higher in urban private than in government settings, and higher in rural than in urban settings. Presence of fever prompted antibiotic use across all strata. Lower age of patients and higher socioeconomic status were associated with higher antibiotic use. Patient requests for antibiotics were very rare. Specialist practices with staff with higher qualifications and better opportunities for updating knowledge were associated with lower antibiotic prescribing. Government health-facilities with larger staff complement and better infrastructure was associated with lower prescribing rates. The most common antimicrobial agents used were the penicillin, sulfonamides and fluoroquinolones. Injection use paralleled antibiotic use. These data on overprescribing of antibiotics can be used to design educational programs for physicians working in these settings.Keywords
This publication has 20 references indexed in Scilit:
- Factors affecting antibiotic prescribing pattern in pediatric practice.Indian Journal of Pediatrics, 2005
- Caregivers' practices, knowledge and beliefs of antibiotics in paediatric upper respiratorytract infections in Trinidad and Tobago: a cross-sectional studyBMC Family Practice, 2004
- Racial/Ethnic Variation in Parent Expectations for Antibiotics: Implications for Public Health CampaignsPEDIATRICS, 2004
- The knowledge and expectations of parents about the role of antibiotic treatment in upper respiratory tract infection – a survey among parents attending the primary physician with their sick childBMC Family Practice, 2003
- Trends in Antimicrobial Prescribing for Bronchitis and Upper Respiratory Infections Among Adults and ChildrenAmerican Journal of Public Health, 2003
- Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet * Commentary: More self reliance in patients and fewer antibiotics: still room for improvementBMJ, 2002
- Use of cold medications for upper respiratory tract infections in childrenPharmacoepidemiology and Drug Safety, 2001
- Decision making, evidence, audit, and education: case study of antibiotic prescribing in general practice Commentary: What can we learn from narratives of implementing evidence?BMJ, 2000
- Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throatsBMJ, 1998
- The use of antimicrobial drugs in Nagpur, India. A window on medical care in a developing countrySocial Science & Medicine (1982), 1994