Indications and patterns of antibiotic prescription in the Buea Regional Hospital of Cameroon.

Emmanuel Acha Asongalem, Gottlieb Lobe Monekosso, Leonard Ambindei Mbam

Abstract


ABSTRACT

BACKGROUND: Irrational drug use has been a global problem over the time and has a serious repercussion on the patient and even the prescriber.  With the discovery of many drugs especially antibiotics in the last century, many prescribers have had the tendency of either under or over prescribing these drugs to patients, a habit which may negatively affect the patient.

OBJECTIVES: The main aim of this study was to describe pattern of antibiotic prescription in the Buea Regional Hospital (BRH), over a one year period (June 2012 and June 2013).

METHODS: It was a cross-sectional and retrospective descriptive study using prescription sheets of both inpatients and outpatients. Data obtained were analysed using Epi Info statistical software.

RESULTS: There were 1,576 prescribed drugs from 425 prescriptions with at least an antibiotic, with the mean number of drug per prescription being 3.7±1.3drugs and a mode of 3 drugs per prescription (38.8%, 95% C.I). As much as 47.5% had more than 4 drugs per encounter. More so, 637 antibiotics were prescribed giving a  proportion of antibiotics per encounter of 40.4% with a mean of 1.5±0.7drugs, and the most commonly prescribed antibiotics was ceftriaxone, 191(30.0%) and metronidazole, 119(18.7%). The cephalosporins (30.0%) and penicillins (25.8%) were the most common class of antibiotics. 43.8% of the antibiotics were prescribed by brand names and 50.1% were administered via parenteral routes. The mean duration of antibiotic therapy was 5.5±4.5days. The most frequent indications of antibiotic prescription were gastrointestinal tract infections (22.6%) and respiratory tract infections (15.3%). There were 14.6% of the prescriptions with no indication clearly written and 6.4% had no information relating to the prescriber.

CONCLUSION: Antibiotic prescription in the BRH was inappropriate with main reason being lack of clearly defined working diagnosis. Polypharmacy is a big problem in this health facility. Ceftriaxone was the most frequently prescribed antibiotic with gastrointestinal tract infection being the most indication.

KEYWORDS: prescription, antibiotics, rational drug use, polypharmacy.

 


RÉSUMÉ

CONTEXTE : L’usage irrationnel des médicaments est devenu un problème mondial au fil du temps et a de graves répercussions sur le patient et le prescripteur. Avec la découverte de nombreux médicaments particulièrement des antibiotiques au cours du siècle dernier, de nombreux prescripteurs ont une tendance soit vers la sous soit vers la sur prescription de ces médicaments, une habitude qui peut avoir des répercussions négatives sur le patient.

OBJECTIFS : L'objectif principal de cette étude était de décrire les habitudes de prescription des antibiotiques au sein de l'Hôpital Régional de Buea (BRH), sur une période d’un an (juin 2012 et juin 2013).

MÉTHODES : Il s'agit d'une étude transversale, rétrospective et descriptive basée sur l’exploitation des feuilles de prescription des patients hospitalisés et non hospitalisés. Les données obtenues ont été analysées en utilisant le logiciel Epi Info.

RÉSULTATS: Il y a eu 1 576 médicaments prescrits, et 425 ordonnances avaient au moins un antibiotique. Le nombre moyen de médicaments par ordonnance était 3,7 ± 1,3 et le mode était de 3 médicaments par ordonnance (38,8 %, 95% C. I).

47,5 % des ordonnances avaient plus de 4 médicaments par consultation. 637 antibiotiques ont été prescrits donnant une proportion d'antibiotiques par rencontre de 40,4 % avec une moyenne de 1,5 ± 0,7 antibiotiques, et les antibiotiques les plus couramment prescrits était la ceftriaxone, 191 ( 30,0 %) et le métronidazole, 119( 18,7 %). Les céphalosporines (30.0 %) et les pénicillines (25,8 %) ont été les classes d'antibiotiques les plus fréquentes. 43,8 % des antibiotiques étaient des médicaments de spécialités (marques) et 50,1 % ont été administrés par voie parentérale. La durée moyenne de l'antibiothérapie était de 5,5 ± 4,5 jours. Les indications plus fréquentes de prescription des antibiotiques étaient les infections du tractus gastro-intestinal (22,6 %) et les infections des voies respiratoires (15,3 %). Pour 14,6 % des prescriptions, aucune indication n’était clairement écrite et 6,4 % n'avaient aucune information concernant le prescripteur.

CONCLUSION: La prescription des antibiotiques est largement inappropriée à l’Hôpital Régional de Buéa et la raison principale est le manque de définition claire du diagnostic. La polymédication  est un gros problème dans cet établissement de santé. La ceftriaxone est l’antibiotique le plus fréquemment prescrit,  les infections du tractus gastro-intestinal étant l’indication la  plus fréquente.

MOTS-CLÉS : Prescription, antibiotiques, utilisation rationnelle des médicaments, polymédication.


Keywords


prescription, antibiotics, rational drug use, polypharmacy.

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