Seasonality and physician-related factors associated with antibiotic prescribing: A cross-sectional study in Isfahan, Iran

Abstract

Background:Irrational antibiotic prescribing as a global health problem has a major influence on medical care quality and healthcare expenditure. This study was aimed to determine the pattern of antibiotic use and to assess the seasonality and physician-related factors associated with variability in antibiotic prescribing in Isfahan province of Iran.Methods:This cross-sectional survey was conducted on all prescriptions issued by general physicians from rural and urban areas in 2011. Associations between season of prescribing and physician-related variables including gender, practice location and time since graduation with antibiotic prescriptions and also the pattern of antibiotic prescribing were assessed using Chi-square tests and multiple logistic regression models.Results:Of the 7439709 prescriptions issued by 3772 general practitioners, 51% contained at least one antibiotic. Penicillins were the most frequently prescribed antibiotics, followed by cephalosporins and macrolides. Over-prescription of penicillins was associated with female gender (odds ratio [OR], 2.61; 95% confidence interval [CI] 2.13–3.19) and with moderate duration of time in practice (10–20 years) (OR, 1.42; 95% CI 1.14–1.76). Higher rates of cephalosporins prescription were observed in urban areas than rural areas and by male physicians. Seasonal peak was detected for penicillins and cephalosporins prescriptions in autumn.Conclusions:These findings showed the widespread use of antibiotics by general practitioners that was associated with the physicians’ gender, time since graduation and practice location and also season of prescribing. More researches are needed on other factors related to the overprescribing of antibiotics and they could be used to project educational programs for improvement of antibiotic prescribing quality in our country.

Pattern and determinants of antibiotic mal-prescription by family physicians in primary health care facilities of Iran

“…Another related factor to the antibiotic prescribing in the present study was the impact of the seasons so that the number of antibiotic prescriptions increased as the cold season came. This nding is in agreement with national studies [11,21].…”

“…It may have resulted from cultural-social factors and believing the high effect of injecting form of drugs by the patients which, besides being expensive in regard to oral form, sometimes are dangerous for patients [29]. Another reason maybe the existence of injecting section in most of therapeutic and health centers and following the desire of patients to receive whole services from the place of their refer [11,17]. Amoxicillin and Penicillin were the most commonly prescribed drug in our study and also a study of Dong and et al in China [30].…”

“…It is reported that the antibiotics are used as common drugs in Iran and almost half of the patients receive at least one antibiotic during doctor-patient encounters. It is also estimated that more than 8% of hospital admissions in Iran occur due to adverse drug reactions [5,10,11]. Accordingly, rational and appropriate drug prescription, especially the antibiotics, will decrease antibiotics resistance, adverse drug reactions, toxicity risks, healthcare expenditure and household costs, and duration of therapy at the global level [11,12].…”

Primary Health Care and Cervical Cancer Mortality Rates in Brazil

“…Therefore, these studies recommended the implementation of cervical cancer screening as part of ensured PHC scope in developing countries (Bobdey et al, 2015). …”

Use of antibiotics by adults: a population-based cross-sectional study

“…Total frequencies of antibiotic consumption and numbers of cases of self-medication with each drug over the last 15 days prior to the interview.Seasonality affects the consumption of antibiotics: the highest frequency of prescription is usually reported during the fall (autumn) and winter,15,16 seasons that occur between March and September in most of Brazil. The state of Amazonas presents an equatorial climate, characterized by average temperatures of 26 to…”