Andree Zamunu1, Wendy Pameh2, Paulus Ripa3, John Vince2, Trevor Duke2,4. 1. a Popendetta General Hospital , Popondetta , Oro Province , Papua New Guinea. 2. b School of Medicine and Health Sciences , University of Papua New Guinea , Port Moresby , Papua New Guinea. 3. c Mount Hagen General Hospital, Western Highlands Province , Mount Hagen , Papua New Guinea. 4. d Centre for International Child Health , University of Melbourne, Royal Children's Hospital , Melbourne , Australia.
Abstract
BACKGROUND: Antibiotic prescribing for self-limiting viral infections such as the common cold or viral upper respiratory tract infection (URTI) is irrational and increases the risk of antibiotic resistance. However, such a practice is widespread and is likely to be as common in Papua New Guinea as in many other countries. METHODS: In a cross-sectional descriptive study, children were recruited who had been diagnosed with a common cold or URTI by attending clinical staff-mostly nurses-in a provincial hospital's children's outpatient department using a standard definition. The frequency of antibiotic prescribing was determined and the clinical knowledge and practices of nurses, health extension officers, community health workers and doctors working in the children's outpatients department regarding the common cold and its management was assessed. RESULTS: One hundred and eight children diagnosed with the common cold were enrolled; 89 (82.4%) were prescribed antibiotics. Children with fever on examination, those older than 12 months and those whose symptoms lasted ≥7 days were more likely to be prescribed antibiotics. Of the health workers surveyed, 95% knew that viruses were the cause of the common cold, but 30% thought that antibiotics were needed for treatment. CONCLUSIONS: Although among healthcare workers, there was a gap between knowledge of aetiology and knowledge of appropriate management of the common cold, there was a larger apparent gap between that knowledge and practice. Findings from this study could be used to identify interventions promoting rational antibiotic use, targeting both health-care workers and the community.
BACKGROUND: Antibiotic prescribing for self-limiting viral infections such as the common cold or viral upper respiratory tract infection (URTI) is irrational and increases the risk of antibiotic resistance. However, such a practice is widespread and is likely to be as common in Papua New Guinea as in many other countries. METHODS: In a cross-sectional descriptive study, children were recruited who had been diagnosed with a common cold or URTI by attending clinical staff-mostly nurses-in a provincial hospital's children's outpatient department using a standard definition. The frequency of antibiotic prescribing was determined and the clinical knowledge and practices of nurses, health extension officers, community health workers and doctors working in the children's outpatients department regarding the common cold and its management was assessed. RESULTS: One hundred and eight children diagnosed with the common cold were enrolled; 89 (82.4%) were prescribed antibiotics. Children with fever on examination, those older than 12 months and those whose symptoms lasted ≥7 days were more likely to be prescribed antibiotics. Of the health workers surveyed, 95% knew that viruses were the cause of the common cold, but 30% thought that antibiotics were needed for treatment. CONCLUSIONS: Although among healthcare workers, there was a gap between knowledge of aetiology and knowledge of appropriate management of the common cold, there was a larger apparent gap between that knowledge and practice. Findings from this study could be used to identify interventions promoting rational antibiotic use, targeting both health-care workers and the community.
Entities:
Keywords:
Antibiotic stewardship; Papua New Guinea; children; respiratory tract infections
Authors: Michael Loftus; Andrew Stewardson; Ravi Naidu; Ben Coghlan; Adam Jenney; Jonila Kepas; Evelyn Lavu; Alex Munamua; Trisha Peel; Vinita Sahai; Rosemary Tekoaua; Litia Tudravu; Julie Zinihite; Allen Cheng; Eric Rafai; Anton Peleg Journal: BMJ Glob Health Date: 2020-04