Retrospective Analysis of Antibiotic Prescribing Pattern for Upper Respiratory Tract Infection (URTI) in Seremban 2 Health Clinic

Abstract

Introduction: URTI is a common problem seen in primary care. URTIs are often of viral origin and therefore the use of antibiotics are not necessary. Overprescribing of antibiotics can lead to antibiotic resistance. Objectives: 1) Determine the antibiotic prescribing pattern for URTI at Seremban 2 Health Clinic. 2) Determine the appropriateness of antibiotics prescribed for URTI based on Malaysian National Antibiotic Guideline (MNAG) 2014 and the defined daily dose (DDD) system introduced by WHO. Method: Information was collected from Pharmacy Information System (PhIS). All records of patients attending the clinic from 1st January 2018 to 31st December 2018, who fulfilled the necessary criteria were screened and retrieved for further investigation. The data obtained was analysed using IBM SPSS Statistics version 25.0 (IBM Corp., Armonk, NY, USA). Results: URTI was found to be the most common diagnosis, which accounted for about 27.0% from the total diagnosis for which antibiotics were prescribed. The overall antibiotic prescribing rate and URTI antibiotic prescribing rate in the current study were 11.6% and 25.2% respectively. Amoxicillin (49.8%) was the most frequently prescribed antibiotic for the indication of URTI followed by erythromycin (43.4%), cloxacillin (2.8%), amoxicillin/clavulanic acid (1.8%), cephalexin (1.8%), cefuroxime (0.3%) and doxycycline (0.2%). The most utilized antibiotics for URTI was amoxicillin (1.31 DDD/100 patients), and was used almost 3-fold more than erythromycin which was the second most utilized antibiotic for URTI (0.48 DDD/100 patients). Conclusion: These results show that the current practice is not following the antibiotic guidelines.