Inappropriate antibiotic prescribing: a cross-sectional study in Swaziland
Keywords: ARI, inappropriate antibiotic prescribing, Hlatikulu Government Hospital, OPD
AbstractBackground: A cross-sectional study was performed to determine the one-month prevalence of inappropriate antibiotic prescribing at the outpatient department of Hlatikulu Government Hospital, Swaziland. A survey was also administered to prescribers to determine their knowledge of and attitudes and perceptions towards prescribing for acute respiratory infections (ARIs). Method: The prevalence of inappropriate antibiotic prescribing for ARIs was estimated by reviewing 410 prescriptions over one month. Ten prescribers participated in the survey conducted to assess their knowledge of and attitudes and perceptions towards prescribing for ARIs. Results: Overall, a high prevalence of inappropriate antibiotic prescribing for ARIs was found [79%, 95% confidence interval (CI): 75-83)] with regard to doctors, (78%, 95% CI: 73-83) with regard to nurses, and (80%, 95% CI: 74-87) with respect to all age groups. Amoxicillin was the most misused antibiotic (64%). Prescribers were aware of the local treatment guidelines, although not everybody was confident applying them. Nurses in the survey listed antibiotics as their preferred drug of choice for ARIs. Most doctors displayed knowledge of prescribing for ARIs. All prescribers failed to define rational drug use. Forty per cent of the prescribers reported being influenced by patients in their prescribing practices. Conclusion: Inappropriate antibiotic prescribing for ARIs was rampant. There is a need for strategies to impart knowledge to prescribers, and to translate their knowledge into a change in attitude in order to reduce inappropriate antibiotic prescribing for ARIs.
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