scholarly journals Antibiotic Prescribing Practices of Endodontic Postgraduate Trainees in Karachi, Pakistan

2021 ◽  
Vol 30 (03) ◽  
pp. 183-188
Author(s):  
Azam Muhammad Aliuddin ◽  
◽  
Sarosh Sadruddin Morani ◽  
Abubakar Sheikh ◽  
Saqib Rashid ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Apical Periodontitis ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Post Graduate ◽  
Odontogenic Infections ◽  
First Choice ◽  
Graduate Trainees

OBJECTIVE: The aim of this study was to assess the knowledge of Endodontic Postgraduate trainees regarding clinically relevant situations where an antibiotic cover is needed and is focused on the prescription patterns of various antibiotics depending on the clinical evaluation of the patients. METHODOLOGY: A cross sectional study was performed in which data was collected from five different dental institutes offering post-graduate residency in endodontics all over Karachi, Pakistan. Preferred antibiotic for odontogenic infections and the duration for the antibiotic coverage were evaluated amongst postgraduate clinicians. A total of 100 questionnaires were distributed out of which only 82 questionnaires came back with responses. The study was conducted for a period of one month from August 2018- September 2018. The data collected was analyzed by SPSS version 21. RESULTS: A combination of amoxicillin with Clavulanic acid was the first choice of antibiotic in patients with no known allergies to penicillin (40.6%), whereas erythromycin was the first choice of antibiotic in patients having allergic reactions to penicillin (39.3%). The duration of treatment on average was 5 days. In clinical situations of irreversible pulpitis, with or without apical periodontitis, 74.3% and 67% of the respondents prescribed antibiotics. 78 % of respondents have prescribed antibiotics in cases of necrotic pulp with acute apical periodontitis. CONCLUSION: Our study concludes that antibiotic over prescription is very common amongst post graduate trainees and is contributing towards a larger issue of antibiotic resistance. Proper protocols of prescription should be followed by professionals and further refinement is required focusing on need, duration and choice of the antibiotic being used. KEYWORDS: Antibiotics, Odontogenic infections, Endodontics, Microbial resistance

scholarly journals Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 858
Author(s):  
Reema A. Karasneh ◽  
Sayer I. Al-Azzam ◽  
Mera Ababneh ◽  
Ola Al-Azzeh ◽  
Ola B. Al-Batayneh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Attitudes And Behaviors ◽  
And Behaviors ◽  
Ease Of Access

More research is needed on the drivers of irrational antibiotic prescribing among healthcare professionals and to ensure effective prescribing and an adequate understanding of the issue of antibiotic resistance. This study aimed at evaluating prescribers’ knowledge, attitudes and behaviors about antibiotic use and antibiotic resistance. A cross-sectional study was conducted utilizing an online questionnaire and included physicians and dentists from all sectors in Jordan. A total of 613 prescribers were included (physicians n = 409, dentists n = 204). Respondents’ knowledge on effective use, unnecessary use or associated side effects of antibiotics was high (>90%), compared with their knowledge on the spread of antibiotic resistance (62.2%). For ease of access to the required guidelines on managing infections, and to materials that advise on prudent antibiotic use and antibiotic resistance, prescribers agreed in 62% and 46.1% of cases, respectively. 28.4% of respondents had prescribed antibiotics when they would have preferred not to do so more than once a day or more than once a week. Among respondents who prescribed antibiotics, 63.4% would never or rarely give out resources on prudent use of antibiotics for infections. The findings are of importance to inform antibiotic stewardships about relevant interventions aimed at changing prescribers’ behaviors and improving antibiotic prescribing practices.

scholarly journals Analysis of patterns of antibiotic prescribing in public health facilities in Nepal

2020 ◽  
Vol 14 (01) ◽  
pp. 18-27 ◽  
Author(s):  
Anant Nepal ◽  
Delia Hendrie ◽  
Suzanne Robinson ◽  
Linda A Selvey
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Antibiotic Prescribing ◽  
Who Guidelines ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Middle Income ◽  
Public Health Facilities ◽  
Inappropriate Use

Introduction: Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. Little is known about antibiotic prescribing practices at public health facilities in low- and middle-income countries. We examined patterns of antibiotic prescribing in public health facilities in Nepal and explored factors influencing these practices. Methodology: A cross-sectional study of antibiotic prescribing in public health facilities was conducted in the Rupandehi district of Nepal. Six public health facilities were selected based on WHO guidelines, and data were extracted from administrative records for 6,860 patient encounters. Patterns of antibiotic prescribing were investigated using descriptive statistics. Chi-squared tests and logistic regressions were applied to explore factors associated with antibiotic prescribing. Results: Of patients attending public health facilities, the proportion prescribed at least one antibiotic (44.7%) was approximately twice the WHO recommended value (20.0 to 26.8%). The antibiotic prescribing rate for hospital inpatients (64.6%) was higher than for other facilities, with the prescribing rate also high in primary health care centres (50.4%) and health posts (52.2%). The most frequently (29.9%) prescribed antibiotic classes were third-generation cephalosporins. Females (p = 0.005) and younger (p < 0.001) patients were more likely to be prescribed antibiotics. High prescribing rates of antibiotics for selected diseases appeared contrary to international recommendations. Conclusion: Antibiotic prescribing in public health facilities was high compared with WHO guidelines, suggesting the need for strategies to reduce misuse of antibiotics. This study provides useful information to assist in formulating policies and guidelines to promote more appropriate use of antibiotics in Nepal.

scholarly journals Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Nebyu Daniel Amaha ◽  
Dawit G. Weldemariam ◽  
Nuru Abdu ◽  
Eyasu H. Tesfamariam
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Essential Medicines ◽  
Community Pharmacies ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Factors Affecting

Abstract Background Antibiotics require more prudent prescribing, dispensing and administration than other medicines because these medicines are at a greater risk of antimicrobial resistance (AMR). Studying the current medicine use practices and factors affecting the prescribing of an antibiotic would help decision makers to draft policies that would enable a more rational use of medicines. Methods A prospective, descriptive, and cross-sectional study was conducted to assess the current prescribing practices including antibiotics use in six community pharmacies in Asmara. A total of 600 encounters were reviewed using the WHO core prescribing indicators between May 5 and May 12, 2019 using stratified random sampling technique. Descriptive statistics and logistic regression were employed using IBM SPSS® (version 22). Results The average number of medicines per prescription was 1.76 and 83.14% of the medicines were prescribed using generic names while 98.39% of the medicines were from the National Essential Medicines List (NEML). The percentage of prescriptions containing antibiotics was 53%. The number of encounters containing injections was 7.8%. Patient age, gender and number of medicines prescribed were significantly associated with antibiotic prescribing at bivariate and multivariable models. Subjects under the age of 15 were approximately three times more likely to be prescribed antibiotic compared to subjects whose age is 65 and above (Adjusted Odds Ratio (AOR): 2.93, 95%CI: 1.71–5). Similarly, males were more likely to be prescribed antibiotic than females (AOR: 1.57, 95%CI: 1.10–2.24). Subjects to whom three to four medicines prescribed were two times more likely to be prescribed an antibiotic compared to those who were to be prescribed one to two medicines per encounter (AOR: 2.17, 95%CI: 1.35–3.5). A one-unit increase in the number of medicines increased the odds of antibiotic prescribing increased by 2.02 units (COR: 2.02; 95%CI: 1.62–2.52). Conclusions This study found that the percentage of antibiotics being prescribed at the community pharmacies in Asmara was 53% which deviated significantly from the WHO recommended values (20–26.8%). Furthermore, the percentage of encounters with an injection was 7.8% lower than the WHO value of 13.4–24.0%. Patients’ age, gender and number of medicines were significantly associated with antibiotic prescribing.

scholarly journals Survey of the pattern of antibiotic dispensing in private pharmacies in Nepal

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032422 ◽  
Author(s):  
Anant Nepal ◽  
Delia Hendrie ◽  
Suzanne Robinson ◽  
Linda A Selvey
Keyword(s):  
Respiratory Infections ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Study Data ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Middle Income ◽  
Frequency Distributions ◽  
Low Middle Income Countries

ObjectivesPrivate pharmacies are widely established in most low/middle-income countries (LMICs) including Nepal, and are often considered as a patient’s first point of contact for seeking healthcare. The aim of this study was to investigate the pattern of antibiotic dispensing in private pharmacies through exit interviews with patients to review their medication information.Design and settingCross-sectional study. Data collection was carried out in 60 days at 33 randomly selected private pharmacies in the Rupandehi district of Nepal.ParticipantsPatients attending private pharmacies (n=1537).Main outcome measureThe pattern of antibiotic prescribing and dispensing was investigated using WHO’s core prescribing indicator, ‘the percentage of patients prescribed an antibiotic’. Frequency distributions were presented based on patients’ characteristics, sources of antibiotic, registration status of pharmacies and education of the pharmacist or drug retailer, and disease or condition. χ2tests and regression analysis were applied to explore factors associated with the pattern of antibiotic dispensing.ResultsOf patients attending private pharmacies, the proportion receiving at least one antibiotic (38.4%) was above the WHO recommended value (20.0%–26.8%). The most commonly dispensed antibiotics were cefixime (16.9%) and the third-generation cephalosporins (38.0%) class. High dispensing rates of antibiotics for selected conditions (eg, respiratory infections, diarrhoeal cases) appeared contrary to international recommendations. The percentage of antibiotic dispensed was highest for patients who obtained their medicines from unlicensed pharmacies (59.1%). Young people were more likely to receive antibiotics than other age groups.ConclusionsThe antibiotic dispensing pattern from private pharmacies in Nepal was high compared with WHO guidelines, suggesting initiatives to reduce inappropriate use of antibiotics should be implemented. The findings of this study may be generalisable to other LMICs in order to assist in developing policies and guidelines to promote more appropriate dispensing and prescribing practices of antibiotics and limit the spread of antibiotic resistance.

scholarly journals An observational and cross-sectional study on drug utilization pattern in the ophthalmology out-patient department of a tertiary care center of Bihar

2021 ◽  
Vol 6 (4) ◽  
pp. 194-196
Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar
Keyword(s):  
Drug Utilization ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Duration Of Treatment ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Institutional Ethics

Making affordable drugs accessible to all strata of society is an inevitable part of health care. This situation makes Drug Utilization Study inevitable. With this background, the current study was planned to obtain knowledge on the prescribing pattern and drug utilization trend in ophthalmology department at a tertiary care teaching hospital with ultimate goal to promote rational use of drugs among prescribers. An observational cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between March 2021 and August 2021. Prescriptions of 550 patients who were treated during the course of the study were surveyed prospectively by using a specially designed form. The WHO drug use indicators like prescribing indicators and patient care indicators were determinedThe average number of drugs per prescription was 2.6, ranging from 0-7 drugs. The dosage forms, the frequency of administration and duration of treatment of the drugs were recorded for 99.9% of the prescriptions given. This analysis of the prescriptions showed that 93.8% of the prescriptions were written in the form of various trade names. Antibiotics were prescribed in 52.5% of the prescriptions. The present study revealed certain lacunae in the prescribing practices of the Ophthalmologists at the selected institute and this is evident by the low generic prescribing in many prescriptions.

scholarly journals Drug Use Evaluation of Crystalline Penicillin in Pediatrics Ward of Dessie Referral Hospital, North East Ethiopia: A Hospital Based Cross Sectional Study

2020 ◽  
Author(s):  
Taklo Simeneh Yazie ◽  
Ayalneh Gedif Tessema
Keyword(s):  
Drug Interaction ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
North East ◽  
Significant Difference ◽  
Dessie Referral Hospital

Background: Antibiotic resistance is a worldwide issue due to rise of antibiotic consumption and wide variation in antibiotic prescribing practices. Crystalline penicillin is the most highly consumed antibiotics by hospitalized pediatrics patients in Dessie Referral Hospital and its utilization pattern is not known in the study area. The objective is to assess the appropriateness of crystalline penicillin use in pediatrics ward of Dessie Referral Hospital, Northeast Ethiopia. Methods: A hospital based cross-sectional study was used for evaluating medication records of hospitalized pediatric patients who received crystalline penicillin from October to December 2018. Results: A total of 262 hospitalized pediatrics patient records were included in the study. All the 262 (100%) cases were consistent with guidelines for contraindication and drug interaction to use the drug. Crystalline penicillin use was consistent with guideline recommendations in 93.8%, 92.8%, 89.6%, 66.7% and 39.4% of the cases with regard to, indication, outcome, frequency, dose and duration of treatment, respectively. The observed value of all drug utilization evaluation parameters except drug interaction and contraindication showed statistically significant difference from the set threshold in nonparametric binomial test. Conclusion: The result of the current study especially with regard to dose and duration is much below the recommended threshold and needs scheduled trainings and necessary interventions to tackle the problem.

scholarly journals Antibiotic prescribing practices of dentists for endodontic infections; a cross-sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244585
Author(s):  
Sheela B. Abraham ◽  
Nizam Abdulla ◽  
Wan Harun Himratul-Aznita ◽  
Manal Awad ◽  
Lakshman Perera Samaranayake ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Cross Sectional Study ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Systemic Involvement ◽  
Dental Practitioners ◽  
Significant Difference ◽  
Endodontic Infections

Objective The indiscriminate prescription of antibiotics has led to the emergence of resistance microbes worldwide. This study aimed to investigate the antibiotic prescribing practices amongst general dental practitioners and specialists in managing endodontic infections in the United Arab Emirates (UAE). Design General dental practitioners and specialists in the UAE were invited to participate in an online questionnaire survey which included questions on socio-demographics, practitioner’s antibiotic prescribing preferences for various pulpal and periapical diseases, and their choice, in terms of the type, dose and duration of the antibiotic. The link to the survey questionnaire was sent to 250 invited dentists. Data were analyzed by descriptive statistics and chi-square tests for independence and level of significance was set at 0.05. Results A total of 174 respondents participated in the survey (response rate = 70%). The respondents who prescribed antibiotics at least once a month were 38.5% while 17.2% did so, more than three times a week; amoxicillin 500 mg was the antibiotic of choice for patients not allergic to penicillin (43.7%), and in cases of penicillin allergies, erythromycin 500 mg (21.3%). There was a significant difference in the antibiotic prescribing practices of GDPs compared to endodontists and other specialties especially in clinical cases such as acute apical abscesses with swelling and moderate to severe pre-operative symptoms and retreatment of endodontic cases (p<0.05). Approximately, three quarters of the respondents (78.7%) did not prescribe a loading dose when prescribing antibiotics. About 15% respondents prescribed antibiotics to their patients if they were not accessible to patients due to a holiday/weekend. Conclusions In general, the antibiotic prescribing practices of UAE dentists are congruent with the international norms. However, there were occasions of inappropriate prescriptions such as in patients with irreversible pulpitis, necrotic pulps with no systemic involvement and/or with sinus tracts.

scholarly journals Exploring Information Available to and Used by Physicians on Antibiotic Use and Antibiotic Resistance in Jordan

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 963
Author(s):  
Reema A. Karasneh ◽  
Sayer I. Al-Azzam ◽  
Mera A. Ababneh ◽  
Iman A. Basheti ◽  
Ola Al-Azzeh ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Medical Professional ◽  
Antibiotic Prescribing ◽  
Action Plans ◽  
Sources Of Information ◽  
Prescribing Practices ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Body

Evidence based information sources for physicians are needed for informed antibiotic prescribing practices. The aim of this study was to explore physicians’ preferred sources of information and evaluate physicians’ awareness of available information and initiatives on prudent antibiotic prescribing in Jordan. A cross-sectional study was conducted utilizing an online questionnaire and included physicians (n = 409) from all sectors and specialties in Jordan. Published guidelines (31.8%), the workplace (25.7%), colleagues or peers (20.0%), group or conference training (18.3%), and the medical professional body (18.1%) were the main sources of information about avoiding unnecessary antibiotic prescribing, with the influence of these sources on changing prescribers’ views being 34.7%, 17.1%, 11%, 13.4%, and 7.6%, respectively. One-third of physicians (33.7%) reported no knowledge of any initiatives on antibiotic awareness and resistance. Regarding awareness of national action plans on antimicrobial resistance, 10.5%, 34%, and 55.5% of physicians were aware, unaware, and unsure of the presence of any national action plans, respectively. Physicians showed interest in receiving more information on resistance to antibiotics (58.9%), how to use antibiotics (42.2%), medical conditions for which antibiotics are used (41.3%), prescribing of antibiotics (35.2%), and links between the health of humans, animals, and the environment (19.8%). The findings can inform interventions needed to design effective antimicrobial stewardship, enabling physicians to prescribe antibiotics appropriately.

scholarly journals Relationship between prescribing of antibiotics and other medicines in primary care: a cross-sectional study

2018 ◽  
Vol 69 (678) ◽  
pp. e42-e51 ◽  
Author(s):  
Yan Li ◽  
Anna Mölter ◽  
Andrew White ◽  
William Welfare ◽  
Victoria Palin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
General Practices ◽  
The Uk

BackgroundHigh levels of antibiotic prescribing are a major concern as they drive antimicrobial resistance. It is currently unknown whether practices that prescribe higher levels of antibiotics also prescribe more medicines in general.AimTo evaluate the relationship between antibiotic and general prescribing levels in primary care.Design and settingCross-sectional study in 2014–2015 of 6517 general practices in England using NHS digital practice prescribing data (NHS-DPPD) for the main study, and of 587 general practices in the UK using the Clinical Practice Research Datalink for a replication study.MethodLinear regression to assess determinants of antibiotic prescribing.ResultsNHS-DPPD practices prescribed an average of 576.1 antibiotics per 1000 patients per year (329.9 at the 5th percentile and 808.7 at the 95th percentile). The levels of prescribing of antibiotics and other medicines were strongly correlated. Practices with high levels of prescribing of other medicines (a rate of 27 159.8 at the 95th percentile) prescribed 80% more antibiotics than low-prescribing practices (rate of 8815.9 at the 5th percentile). After adjustment, NHS-DPPD practices with high prescribing of other medicines gave 60% more antibiotic prescriptions than low-prescribing practices (corresponding to higher prescribing of 276.3 antibiotics per 1000 patients per year). Prescribing of non-opioid painkillers and benzodiazepines were also strong indicators of the level of antibiotic prescribing. General prescribing levels were a much stronger driver for antibiotic prescribing than other risk factors, such as deprivation.ConclusionThe propensity of GPs to prescribe medications generally is an important driver for antibiotic prescribing. Interventions that aim to optimise antibiotic prescribing will need to target general prescribing behaviours, in addition to specifically targeting antibiotics.

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