Yohana Mashalla1, Vincent Setlhare2, Amos Massele1, Enoch Sepako1, Celda Tiroyakgosi3, Joyce Kgatlwane4, Mpo Chuma5, Brian Godman6,7,8. 1. Department of Biomedical Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana. 2. Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana. 3. Ministry of Health, Gaborone, Botswana. 4. School of Allied Health Professions, University of Botswana, Gaborone, Botswana. 5. School of Public Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana. 6. Department of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden. 7. Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK. 8. Health Economics Centre, University of Liverpool Management School, Liverpool, UK.
Abstract
BACKGROUND AND AIMS: Inappropriate drug prescribing has increased especially in developing countries where systems for monitoring medicine use are not well developed. This increases the rate of antimicrobial resistance. The study aim was to assess the prescribing patterns among urban primary health facilities in Botswana to provide future guidance including developing future quality indicators. METHODS: Retrospective data from patients' records between January and December 2013 in 19 clinics were collected in a cross-sectional study. The WHO/International Network for Rational Use of Drugs indicators were used to assess prescribing patterns in the study clinics. RESULTS: Average number of drugs per prescription was 2.8; 78.6% of the prescribed antibiotics were by International Non-proprietary Name and 96.1% complied with the Botswana Essential Drugs List. Overall rate of antibiotic prescribing was high (42.7%) with 14.7%, 5.9% and 1.3% of prescriptions having two, three and four antibiotics, respectively. Systemic antibiotics (JO1C) accounted for 45.4% of prescribed antibiotics of which amoxicillin accounted for 28.4% and metronidazole 14.4% of all antibiotic prescriptions. There was low use of co-amoxiclav (0.3% of all antibiotic prescriptions). Third generation cephalosporins and macrolides accounted for 9.8% and 6.2% of antibiotic prescriptions respectively, with no prescribing of fluoroquinolones. The majority of indications (87%) for antibiotic prescriptions were according to ICD classification. CONCLUSIONS: While most indications for antibiotic prescriptions were based on signs and symptoms according to ICD, antibiotic prescribing rates were high with some conditions not requiring antibiotics because they are viral infections. There is a need to further improve prescribing practices through induction and training of in-service prescribers. An effective management tool for monitoring antibiotic prescribing practices at Primary Health Care facilities should be designed and implemented, including developing robust quality indicators.
BACKGROUND AND AIMS: Inappropriate drug prescribing has increased especially in developing countries where systems for monitoring medicine use are not well developed. This increases the rate of antimicrobial resistance. The study aim was to assess the prescribing patterns among urban primary health facilities in Botswana to provide future guidance including developing future quality indicators. METHODS: Retrospective data from patients' records between January and December 2013 in 19 clinics were collected in a cross-sectional study. The WHO/International Network for Rational Use of Drugs indicators were used to assess prescribing patterns in the study clinics. RESULTS: Average number of drugs per prescription was 2.8; 78.6% of the prescribed antibiotics were by International Non-proprietary Name and 96.1% complied with the Botswana Essential Drugs List. Overall rate of antibiotic prescribing was high (42.7%) with 14.7%, 5.9% and 1.3% of prescriptions having two, three and four antibiotics, respectively. Systemic antibiotics (JO1C) accounted for 45.4% of prescribed antibiotics of which amoxicillin accounted for 28.4% and metronidazole 14.4% of all antibiotic prescriptions. There was low use of co-amoxiclav (0.3% of all antibiotic prescriptions). Third generation cephalosporins and macrolides accounted for 9.8% and 6.2% of antibiotic prescriptions respectively, with no prescribing of fluoroquinolones. The majority of indications (87%) for antibiotic prescriptions were according to ICD classification. CONCLUSIONS: While most indications for antibiotic prescriptions were based on signs and symptoms according to ICD, antibiotic prescribing rates were high with some conditions not requiring antibiotics because they are viral infections. There is a need to further improve prescribing practices through induction and training of in-service prescribers. An effective management tool for monitoring antibiotic prescribing practices at Primary Health Care facilities should be designed and implemented, including developing robust quality indicators.
Authors: Marina Morgado Garcia; Pamela Santos Azevedo; Andrew Mirelman; Leandro Pinheiro Safatle; Roberto Iunes; Marion Clark Bennie; Brian Godman; Augusto Afonso Guerra Junior Journal: Front Pharmacol Date: 2020-04-14 Impact factor: 5.810
Authors: Ayukafangha Etando; Adefolarin A Amu; Mainul Haque; Natalie Schellack; Amanj Kurdi; Alian A Alrasheedy; Angela Timoney; Julius C Mwita; Godfrey Mutashambara Rwegerera; Okwen Patrick; Loveline Lum Niba; Baffour Boaten Boahen-Boaten; Felicity Besong Tabi; Olufunke Y Amu; Joseph Acolatse; Robert Incoom; Israel Abebrese Sefah; Anastasia Nkatha Guantai; Sylvia Opanga; Ibrahim Chikowe; Felix Khuluza; Dan Kibuule; Francis Kalemeera; Ester Hango; Jennie Lates; Joseph Fadare; Olayinka O Ogunleye; Zikria Saleem; Frasia Oosthuizen; Werner Cordier; Moliehi Matlala; Johanna C Meyer; Gustav Schellack; Amos Massele; Oliver Ombeva Malande; Aubrey Chichonyi Kalungia; James Sichone; Sekelani S Banda; Trust Zaranyika; Stephen Campbell; Brian Godman Journal: Healthcare (Basel) Date: 2021-12-13