Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Study Population and Sample Size
2.3. Data Collection and Analysis
2.4. Ethical Approval
3. Results
3.1. Characteristics of Patients, Pharmacists, and Prescriptions
3.2. Prescribing Practices
3.3. WHO Prescribing Indicators
3.4. Antibiotic Prescribing
3.5. Factors Related with Antibiotic Prescribing
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | N (%)/Median (IQR) | 95% CI |
---|---|---|
Patient characteristics (N = 630) | ||
Age (years) | 29 (14–42) | 27–32 |
Infants: <1 | 13 (2.1) | 1.1–3.3 |
Children: 1–12 | 135 (21.4) | 18.1–24.8 |
Adolescents: 13–17 | 33 (5.2) | 3.3–7.0 |
Adults: 18–64 | 425 (67.5) | 63.8–71.4 |
Old adults: ≥65 | 24 (3.8) | 2.5–5.4 |
Gender | ||
Male | 288 (45.7) | 41.9–49.5 |
Female | 342 (54.3) | 50.5–58.1 |
Prescription characteristics (N = 630) | ||
Prescriber specialty | ||
General practitioner | 365 (57.9) | 54.1–62.1 |
Gynecologist | 49 (7.8) | 5.7–10.0 |
Pediatrician | 35 (5.6) | 3.7–7.3 |
Cardiologist | 22 (3.5) | 2.2–4.9 |
Ophthalmologist | 14 (2.2) | 1.1–3.5 |
Endocrinologist | 3 (0.5) | 0.0–1.1 |
General surgeon | 10 (1.6) | 0.6–2.5 |
Dentist | 27 (4.3) | 2.7–6.0 |
Dermatologist | 25 (4.0) | 2.4–5.4 |
ENT specialist | 50 (7.9) | 5.9–10.2 |
Internal medicine specialist | 30 (4.8) | 3.2–6.5 |
Pharmacist characteristics (N = 21) | ||
Age (years) | 32 (30–34) | 31.5–36.0 |
Gender | ||
Male | 15 (71.4) | 52.4–90.5 |
Female | 6.0 (28.6) | 9.5–47.6 |
Education | ||
BPharm | 13.0 (61.9) | 42.9–81.0 |
PharmD | 5.0 (23.8) | 4.8–42.9 |
Master’ degree | 3.0 (14.3) | 0.0–28.6 |
Work Experience | 5.0 (4.0–7.0) | 4.0–7.0 |
Position in pharmacy | ||
Pharmacist In charge | 6.0 (28.6) | 14.3–47.6 |
Pharmacist | 12.0 (57.1) | 33.3–76.2 |
Assistant Pharmacist | 3.0 (14.3) | 0.0–28.6 |
Type of pharmacy | ||
Independent | 15.0 (71.4) | 52.4–90.5 |
Chain | 6.0 (28.6) | 9.5–47.6 |
Number of prescriptions per day | ||
<100 | 19 (90.5) | 76.2–100 |
100–150 | 2.0 (9.5) | 0.0–23.8 |
Prescribing Indicators | N (%) | 95% CI |
---|---|---|
Number of drugs per prescription | ||
One | 137 (21.7) | 18.4–25.1 |
Two | 174 (27.6) | 24.0–31.3 |
Three | 146 (23.2) | 20.0–26.3 |
Four | 68 (10.8) | 8.6–13.3 |
Five or more | 105 (16.7) | 13.8–19.5 |
Number of drugs prescribed by generic name | ||
None | 261 (41.4) | 37.6–45.4 |
One | 130 (20.6) | 17.3–23.8 |
Two | 83 (13.2) | 10.8–15.7 |
Three | 61 (9.7) | 10.8–15.7 |
Four | 30 (4.8) | 3.0–6.5 |
Five or more | 65 (10.3) | 8.3–12.9 |
Number of drug encounter with antibiotics | ||
None | 354 (56.2) | 52.4–60.0 |
One | 236 (37.5) | 33.7–41.4 |
Two | 39 (6.2) | 4.1–8.3 |
Three | 1 (0.2) | 0.0–0.5 |
Number of drug encounter with injection | ||
None | 627 (99.5) | 98.9–100 |
One | 3 (0.5) | 0.0–1.1 |
Number of drugs prescribed from essential drug list | 529 (84) | 80.8–86.7 |
Prescribing Indicators | Optimal Value | Current Study | Bassoum et al. [2] | Jacob et al. [3] | Amaha et al. [4] | Aravamuthan et al. [5] | Chapagain et al. [6] | Atif et al. [7] | Vooss et al. [8] | Mahalli et al. [9] |
---|---|---|---|---|---|---|---|---|---|---|
Average number of drugs per prescription | 1.6–1.8 | 2.88 | 2.5 | 2.89 | 1.76 | 3.7 | 2.14 | 4.5 | 2.03 | 2.4 |
Percentage of drugs prescribed by generic name | 100% | 58.6 | 7.0 | 0.75 | 83.14 | 8.0 | 45.18 | 23.3 | 72.8 | 61.2 |
Percentage of prescriptions with an antibiotic prescribed | 20.0–26.8% | 43.8 | 40 | 37.8 | 53 | 58.8 | 40.44 | 39.6 | 21.7 | 32.2 |
Percentage of encounters with an injection prescribed | 13.4–24.1% | 0.5 | 7 | 2.74 | 7.8 | 24.3 | 3.44 | 19 | 2.4 | 2 |
Percentage of drugs prescribed from the list of essential drugs | 100% | 83.8 | 32 | 30.08 | 93.39 | 100 | 76.11 | 54.4 | 80.3 | 99.2 |
AWaRe Classification | ||
---|---|---|
Access (%) | Watch (%) | Reserve (%) |
Amoxicillin/clavulanic-acid (22.4) | Azithromycin (4.4) | - |
Amoxicillin (3.3) | Cefixime (4.1) | |
Sulfadiazine (0.2) | Cefuroxime (3.2) | |
Ciprofloxacin (2.2) | ||
Fusidic acid (1.4) | ||
Moxifloxacin (0.8) | ||
Levofloxacin (0.5) | ||
Ofloxacin (0.2) | ||
Ceftriaxone (0.2) |
Variable | Antibiotic Prescribing | Logistic Regression | ||||
---|---|---|---|---|---|---|
No | Yes | COR (95%CI) | p-Value * | AOR (95% CI) | p-Value * | |
Patient age | ||||||
Infants: <1 | 10 (1.6%) | 3 (0.5%) | 1.5 (0.28–8.03) | 0.630 | 1.01 (0.18–5.60) | 0.987 |
Children: 1–12 | 52 (8.3%) | 83 (13.2%) | 7.9 (2.5–24.65) | <0.001 | 7.40 (2.32–23.62) | 0.001 |
Adolescents: 13–17 | 16 (2.5%) | 17 (2.7%) | 5.3 (1.4–18.95) | 0.010 | 5.86 (1.57–21.86) | 0.008 |
Adults: 18–64 | 256 (40.6%) | 169 (26.8%) | 3.3 (1.1–9.82) | 0.032 | 2.77 (0.90–8.54) | 0.075 |
Old adults: ≥65 | 20 (3.2%) | 4 (0.6%) | Ref. | Ref. | ||
Patient gender | ||||||
Male | 154 (24.4%) | 134 (21.3%) | Ref. | Ref. | ||
Female | 200 (31.7%) | 142 (22.5%) | 0.82 (0.59–1.12) | 0.207 | 0.95 (0.68–1.34) | 0.786 |
Prescriber qualification | ||||||
General practitioner | 185 (29.4%) | 180 (28.6%) | 1.71 (1.23–2.36) | 0.001 | 1.84 (1.30–2.60) | 0.001 |
Specialist | 169 (26.8%) | 96 (15.2%) | Ref. | Ref. | ||
Number of drugs per prescription | ||||||
One | 101 (16%) | 36 (5.7%) | Ref. | Ref. | ||
Two | 94 (14.9%) | 80 (12.7%) | 2.38 (1.47–3.87) | <0.001 | 2.82 (1.69–4.69) | <0.001 |
Three | 71 (11.3%) | 75 (11.9%) | 2.96 (1.79–4.88) | <0.001 | 3.21 (1.9–5.43) | <0.001 |
Four | 35 (5.6%) | 33 (5.2%) | 2.64 (1.43–4.86) | 0.002 | 3.019 (1.59–5.73) | 0.001 |
Five or more | 53 (8.4%) | 52 (8.3%) | 2.75 (1.6–4.72) | <0.001 | 3.51 (1.98–6.21) | <0.001 |
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Share and Cite
Rabbani, S.A.; Sridhar, S.B.; Safdar, M.; Rao, P.G.M.; Jaber, A.A.S.; AlAhmad, M.M.; Shaar, K.; Emad, I.; Azim, M.A. Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies. Medicina 2023, 59, 843. https://doi.org/10.3390/medicina59050843
Rabbani SA, Sridhar SB, Safdar M, Rao PGM, Jaber AAS, AlAhmad MM, Shaar K, Emad I, Azim MA. Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies. Medicina. 2023; 59(5):843. https://doi.org/10.3390/medicina59050843
Chicago/Turabian StyleRabbani, Syed Arman, Sathvik B. Sridhar, Maryam Safdar, Padma G. M. Rao, Ammar Ali Saleh Jaber, Mohammad M. AlAhmad, Khaled Shaar, Israa Emad, and Muhammad Abdul Azim. 2023. "Assessment of Prescribing Practices and Factors Related to Antibiotic Prescribing in Community Pharmacies" Medicina 59, no. 5: 843. https://doi.org/10.3390/medicina59050843