An Investigation Of Antibiotic Prescribing In Patients With Upper Respiratory Tract Infections (Urtis) At Katutura Health Centre

ABSTRACT

Upper Respiratory Tract Infections (URTIs) are viral in 80% of the cases (Mazur, 2010) but antibiotic prescribing in these illnesses still remains a problem in many places, where about 60% of patients with URTIs receive antibiotics inappropriately (WHO, 2010).This makes URTIs important targets for strategies aimed at reducing irrational antibiotic use because irrational use of antibiotics leads to the emergence and spread of bacterial resistance, which is a growing global public health concern. Other consequences of irrational use of antibiotics are wastage of resources and adverse effects. The purpose of this study was to explore antibiotic prescribing in patients with URTIs at Katutura Health Centre (KHC).

A descriptive, cross sectional, quantitative design based on patients‟ prescriptions was used. Data was analysed using Epi info version 7.1.1.14 and SPSS version 22.0 statistical packages. Microsoft office excel 2010 was also used for graphical presentation of the results.

The rate of antibiotic prescribing for patients with URTIs at KHC was 78% (95% CI, 74% - 82%). Further analysis with the chi-square test of antibiotic prescribing (response variable) and illness, age, gender and profession (exposure variables) showed that age and illness were significantly associated with antibiotic prescribing (p< 0.05) while gender and profession rank were not. Compliance to treatment guidelines was 47% (CI, 40%-54%). The total cost of antibiotic prescribing in this study was N$ 2406.98, of which non-specific URTIs accounted for 48% (N$ 1150.45). Irrationally prescribed antibiotics accounted for 44 % (N$ 1052.07) and those that were rationally prescribed, 8% (N$ 204.46). The total cost of antibiotic treatment of illnesses assessed for rationally was N$ 1256.5 of which N$ 1052.07 (84%) was the cost of irrationally prescribed antibiotics and N$ 204.46 (16%) for rationally prescribed antibiotics. This showed that the cost of irrational prescribing was costing five times more than that of rational prescribing.

Antibiotic over prescribing is a problem in patients with URTIs. The Ministry of Health and Social Services need to develop or adopt international strategies that deliver proven efficacy in reducing antibiotic prescribing in URTIs. These include developing or adopting antibiotic policies that are specific to URTIs, patient education through literature and media campaigns, and implementing and enforcing continued education for health workers on the judicial use of antimicrobials. Further research is also needed to determine the factors that contribute to antibiotic over prescribing in URTIs.