Antibacterial prescription and the associated factors among outpatients diagnosed with respiratory tract infections in Mbarara Municipality, Uganda

Muwanguzi, Timothy Eria; Yadesa, Tadele Mekuriya; Agaba, Amon Ganafa

doi:10.1186/s12890-021-01739-5

Cited by 11 publications

(13 citation statements)

References 27 publications

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“…This highlights the common practice of antibiotic use in managing RTIs. These findings are consistent with those from public health facilities in Mbarara City, Uganda, which reported an antibiotic encounter rate among RTI patients of 77.6% [8].…”

Section: Appropriateness Of Antibiotic Prescriptionsupporting

confidence: 90%

“…These rates exceeded the acceptable ranges of 0-30% for acute bronchitis and 0-20% for the other RTIs [21]. The rate of antibiotic prescription for acute URTIs was slightly higher than that reported in Mbarara City, Uganda at 68.7% [8], indicating an over-prescription of antibiotics for viral RTIs where they are not required. Comparison with international rates showed that Canada had lower rates for acute bronchitis (52.6%), acute sinusitis (48.4%), and otitis media (39.3%) [28].…”

Section: Appropriateness Of Antibiotic Prescriptionmentioning

confidence: 79%

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Prescription patterns of antibiotics and associated factors among outpatients diagnosed with respiratory tract infections in Jinja City, Uganda, June 2022–May 2023

Igirikwayo,

Migisha,

Mukaga

et al. 2024

Preprint

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Background Most respiratory tract infections (RTIs) are viral and do not require antibiotics, yet their inappropriate prescription is common in low-income settings due to factors like inadequate diagnostic facilities. This misuse contributes to antibiotic resistance. We determined antibiotic prescription patterns and associated factors among outpatients with RTIs in Jinja City, Uganda. Methods We conducted a cross-sectional study at 11 public health facilities in Jinja City, Eastern Uganda, from June 1, 2022, to May 31, 2023. We abstracted all patient records with a diagnosis of RTIs from the outpatient registers for the period of June 1, 2022, to May 31, 2023. An interviewer-administered questionnaire capturing data on prescribing practices and factors influencing antibiotic prescription was administered to drug prescribers in the health facilities. We used modified Poisson regression analysis to identify factors associated with antibiotic prescription. Results Out of 1,669 patient records reviewed, the overall antibiotic prescription rate for respiratory tract infections (RTIs) was 79.8%. For specific RTIs, rates were 71.4% for acute bronchitis, 93.3% for acute otitis media, and 74.4% for acute upper respiratory tract infections (URTIs). Factors significantly associated with antibiotic prescription included access to Uganda Clinical Guidelines [Adjusted prevalence ratio (aPR) = 0.61, 95% CI = 0.01–0.91] and Integrated Management of Childhood Illness guidelines [aPR = 0.14, 95% CI = 0.12–0.87, P = 0.002], which reduced the likelihood of prescription. Prescribers without antibiotic training were more likely to prescribe antibiotics [aPR = 3.55, 95% CI = 1.92–3.98]. Patients with common cold [aPR = 0.06, 95% CI = 0.04–0.20] and cough [aPR = 0.11, 95% CI = 0.09–0.91] were less likely to receive antibiotics compared to those with pneumonia. Conclusion The study reveals a high rate of inappropriate antibiotic prescription for RTIs, highlighting significant challenges in adherence to treatment guidelines. This practice not only wastes national resources but also could contribute to the growing threat of antibiotic resistance. Targeted interventions, such as enforcing adherence to prescription guidelines, could improve prescription practices and reduce antibiotic misuse in this low-income setting.

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Section: Appropriateness Of Antibiotic Prescriptionsupporting

confidence: 90%

Section: Appropriateness Of Antibiotic Prescriptionmentioning

confidence: 79%

Prescription patterns of antibiotics and associated factors among outpatients diagnosed with respiratory tract infections in Jinja City, Uganda, June 2022–May 2023

Igirikwayo,

Migisha,

Mukaga

et al. 2024

Preprint

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“… 7 Antibiotics are generally prescribed to patients with respiratory tract infections on a probabilistic basis in most health facilities in sub‐Saharan Africa, and this can lead to antibiotic resistance. 8 , 9 , 10 , 11 Many health systems in sub‐Saharan Africa do not have an effective antimicrobial stewardship program because of the lack of a proper diagnostic technical platform. 12 , 13 Selective use of antimicrobials based on proper diagnosis (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly identified viruses are influenza, rhinovirus, respiratory syncytial virus, and coronavirus 7 . Antibiotics are generally prescribed to patients with respiratory tract infections on a probabilistic basis in most health facilities in sub‐Saharan Africa, and this can lead to antibiotic resistance 8–11 . Many health systems in sub‐Saharan Africa do not have an effective antimicrobial stewardship program because of the lack of a proper diagnostic technical platform 12,13 .…”

Section: Introductionmentioning

confidence: 99%

Viral etiology of lower respiratory tract infections in adults in the pre‐COVID‐19 pandemic era: A cross‐sectional study in a single center experience from Cameroon

Tchatchouang

Kenmoe

Nzouankeu

et al. 2023

Health Science Reports

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Background and Aims: Respiratory viruses are responsible for the majority of lower respiratory tract infections (LRTIs) worldwide. However, there is a gap on the epidemiology of viral LRTIs in adults in sub-Saharan African countries. In Cameroon, like in other countries, the role of viral respiratory pathogens in the etiology of LRTIs in adults is helpful for clinical management. This study aimed to determine the viral aetiologies of LRTIs among hospitalized adults in a reference center for respiratory diseases in the town of Yaounde in Cameroon and its surroundings. Methods: A cross-sectional study was conducted from January 2017 to January 2018 at Jamot Hospital in Yaounde (Cameroon). Clinical and demographic information; BAL and sputa were collected from hospitalized patients meeting LRTI case definitions. The clinical samples were investigated for respiratory pathogens with a commercial Reverse Transcriptase Real-Time Polymerase Chain Reaction (RT-PCR) targeting 21 viruses, cultures for bacterial and fungal infections. Results: The 77 included adult patients with LRTIs had an appropriate clinical sample for microbial investigations. A viral agent was detected in 22.1% (17/77) samples. The main viruses detected included rhinovirus (10/77), coronavirus (hCoV-OC43 and hCoV-229E), and influenza A virus (3/77 each). A concomitant viral and bacterial co-infection occurred in 7.8% of patients (6/77) while viral co-infection occurred in one patient (1.3%). No Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in clinical samples. Most patients were under antimicrobials before getting diagnosed.

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“…Some studies have suggested that for certain conditions in LMICs, inappropriate prescribing can reach 100% [ 15 ]. A considerable proportion of antibiotics are prescribed inappropriately for acute respiratory tract infections (RTIs), which are essentially viral in origin requiring no antibiotic to aid symptom relief [ 7 , 16 , 17 , 18 , 19 ]. There are a number of factors that influence prescribing behavior.…”

Section: Introductionmentioning

confidence: 99%

Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study

et al. 2022

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The overuse of antibiotics is the main driver of antimicrobial resistance (AMR). However, there has been limited surveillance data on AMR and antibiotic prescribing at a primary healthcare level in South Africa. An observational, analytic, cross-sectional study was undertaken to assess key factors associated with empiric antibiotic prescribing among private sector general practitioners (GPs) in the eThekwini district in South Africa, particularly for patients with acute respiratory infections (ARIs). A semi-structured web-based questionnaire was used between November 2020–March 2021. One hundred and sixteen (55.5%) responding GPs prescribed antibiotics empirically for patients with ARIs more than 70% of the time, primarily for symptom relief and the prevention of complications. GPs between the ages of 35–44 years (OR: 3.38; 95%CI: 1.15–9.88), >55 years (OR: 4.75; 95% CI 1.08–21) and in practice < 15 years (OR: 2.20; 95%CI: 1.08–4.51) were significantly more likely to prescribe antibiotics empirically. Three factors—workload/time pressures; diagnostic uncertainty, and the use of a formulary, were significantly associated with empiric prescribing. GPs with more experience and working alone were slightly less likely to prescribe antibiotics empirically. These findings indicate that a combination of environmental factors are important underlying contributors to the development of AMR. As a result, guide appropriate interventions using a health system approach, which includes pertinent prescribing indicators and targets.

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Antibacterial prescription and the associated factors among outpatients diagnosed with respiratory tract infections in Mbarara Municipality, Uganda

Cited by 11 publications

References 27 publications

Prescription patterns of antibiotics and associated factors among outpatients diagnosed with respiratory tract infections in Jinja City, Uganda, June 2022–May 2023

Prescription patterns of antibiotics and associated factors among outpatients diagnosed with respiratory tract infections in Jinja City, Uganda, June 2022–May 2023

Viral etiology of lower respiratory tract infections in adults in the pre‐COVID‐19 pandemic era: A cross‐sectional study in a single center experience from Cameroon

Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study

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