Abstract
Acute respiratory infections (ARI) are a major public health problem and one of the commonest reasons for visiting primary health care centers (PHC). In developing countries, seventy-five percent of the cases are treated with antibiotics, although the majority are caused by viral infection. Our aim was to observe the pattern of physician practices with respect to ARI, in comparison to WHO protocols and to provide recommendations for health promotion enhancement. The study was conducted in Makkah PHC centers, for 2 months. A total 14 PHC centers were randomly selected. And 908 prescriptions were obtained randomly from general practitioners (GP) and analyzed. We found that males were 522 and females were and 386. Weights were not recorded in 224 (24.7%) cases. In 87 cases (9.6%) no diagnosis was recorded. In 515 (62.34%) of cases, antibiotics were prescribed; most of these cases were of simple common cold, with antibiotics not recommended. To conclude, many physicians in Makkah are not following the WHO guidelines for Acute Respiratory Infection. Educational health programs should be conducted to sensitize the physicians regarding the appropriate method of diagnosis and rational use of antibiotics.
Article PDF
Avoid common mistakes on your manuscript.
References
Francis NA, Butler CC, Hood K, Simpson S, Wood F, Nuttall J. Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing: a cluster randomised controlled trial. BMJ 2009;339;b2885.
UNICEF | The State of World Children 2013 [http://www.unicef.org/sowc2013/].
Reddaiah V, Kapoor SK. Acute respiratory infections in rural underfives. Indian J Pediatr 1988;55;424–6.
Acharya D, Prasanna K, Nair S, Rao R. Acute respiratory infections in children: a community based longitudinal study in South India. Indian J Public Health 2002;47;7–13.
Mitra NK. A longitudinal study on ARI among rural under fives. Indian J Community Med 2001;26;8–11.
Wang H, Zheng Y, Deng J, Wang W, Liu P, Yang F, et al. Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen, China. Virol J 2016;13;1.
Siddiqui MI, Baloch AA, Ahmed SI, Jafri SIA. Audit of prescribing patterns of doctors for the management of acute respiratory infections in children. Elective Med J 2014;2;6–9.
Al-Khaldi YM, Diab MM, Al-Gelban KS, Al-Asmari AS, Al-Amin S, Al-Shahrani MS. Prescribing patterns for acute respiratory infections in primary health care, aseer region, Saudi Arabia. J Family Community Med 2005;12;121–6.
Saeed AA, Bani IA. Prevalence and correlates of acute respiratory infections in children less than two years of age. Saudi Med J 2000;21;1152–6.
van Gageldonk-Lafeber AB, Heijnen M-LA, Bartelds AI, Peters MF, van der Plas SM, Wilbrink B. A case-control study of acute respiratory tract infection in general practice patients in The Netherlands. Clin Inf Dis 2005;41;490–7.
Dyar OJ, Beović B, Vlahović-Palčevski V, Verheij T, Pulcini C. How can we improve antibiotic prescribing in primary care? Expert Rev Anti-infective Therapy 2016;14;403–13.
Urrusuno RF, Dorado MF, Arenas AV, Martino CS, Baena SC, Balosa MCM. Improving the appropriateness of antimicrobial use in primary care after implementation of a local antimicrobial guide in both levels of care. Eur J Clin Pharmacol 2014;70;1011–20.
Nash DR, Harman J, Wald ER, Kelleher KJ. Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections. Arch Pediatr Adolesc Med 2002;156;1114–9.
Goossens H, Ferech M, Vander Stichele R, Elseviers M, Group E P. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. The Lancet 2005;365;579–87.
Petersen I, Hayward AC. Antibacterial prescribing in primary care. J Antimicrobial Chemother 2007;60;i43–i7.
Serna M, Ribes E, Real J, Galván L, Gascó E, Godoy P. High exposure to antibiotics in the population and differences by sex and age. Aten Primaria 2011;43;236–44.
Lallana-Alvarez MJ, Feja-Solana C, Armesto-Gomez J, Bjerrum L, Rabanaque-Hernandez MJ. Outpatient antibiotic prescription in Aragón and the differences by gender and age. Enferm Infecc Microbiol Clin 2012;30;591–6.
Holloway KA, Ivanovska V, Wagner AK, Vialle-Valentin C, Ross-Degnan D. Prescribing for acute childhood infections in developing and transitional countries, 1990–2009. Paediatr Int Child Health 2015;35;5–13.
Arroll B. Antibiotics for upper respiratory tract infections: an overview of Cochrane reviews. Respir Med 2005;99;255–61.
Smith SM, Fahey T, Smucny J, Becker LA. Antibiotics for acute bronchitis. Cochrane Database Syst Rev 2004;4.
Puhan MA, Vollenweider D, Latshang T, Steurer J, Steurer-Stey C. Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review. Respir Res 2007;8;30.
Ong DS, Kuyvenhoven MM, Van Dijk L, Verheij TJ. Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPs. J Antimicrob Chemother 2008;62;587–92.
Llor C, Cots J, Gaspar M, Alay M, Rams N. Antibiotic prescribing over the last 16 years: fewer antibiotics but the spectrum is broadening. Eur J Clin Microbiol Infect Dis 2009;28;893–7.
Adriaenssens N, Coenen S, Versporten A, Muller A, Minalu G, Faes C, et al. European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe (1997–2009). J Antimicrob Chemother 2011;66 Suppl 6;vi3–vi12.
Sarfraz T. Acute respiratory infections in children. Pak Armed Forces Med J 1996;46;28–32.
Ojeniran M, Shouval R, Miskin IN, Moses AE, Shmueli A. Costs of appropriate and inappropriate use of antibiotics in the emergency department. IMAJ-Israel Med Assoc J 2010;12;742.
Murphy M, Bradley C P, Byrne S. Antibiotic prescribing in primary care, adherence to guidelines and unnecessary prescribing-an Irish perspective. BMC Family Pract 2012;13;43.
Martínez MA, Inglada L, Ochoa C, Villagrasa JR. Treatments SSGoA. Assessment of antibiotic prescription in acute urinary tract infections in adults. J Infect 2007;54;235–44.
Tobia CC, Aspinall SL, Good CB, Fine MJ, Hanlon JT. Appropriateness of antibiotic prescribing in veterans with community-acquired pneumonia, sinusitis, or acute exacerbations of chronic bronchitis: a cross-sectional study. Clin Ther 2008;30;1135–44.
Lee C-C, Lee C-H, Chuang M-C, Hong M-Y, Hsu H-C, Ko W-C. Impact of inappropriate empirical antibiotic therapy on outcome of bacteremic adults visiting the ED. Am J Emerg Med 2012;30;1447–56.
Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ 2010;340;c2096.
Butler CC, Hillier S, Roberts Z, Dunstan F, Howard A, Palmer S. Antibiotic-resistant infections in primary care are symptomatic for longer and increase workload: outcomes for patients with E. coli UTIs. Br J Gen Pract 2006;56;686–92.
Revised WHO classification and treatment of pneumonia in children at health facilities: evidence summaries, 2014.
Ramani VK, Pattankar J, Puttahonnappa SK. Acute Respiratory Infections among Under-Five Age Group Children at Urban Slums of Gulbarga City: A Longitudinal Study. J Clin Diagn Res 2016;10;LC08.
Peasah SK, Purakayastha DR, Koul PA, Dawood FS, Saha S, Amarchand R, et al. The cost of acute respiratory infections in Northern India: a multi-site study. BMC Public Health 2015;15;1.
Krishnan A, Amarchand R, Gupta V, Lafond KE, Suliankatchi RA, Saha S, et al. Epidemiology of acute respiratory infections in children-preliminary results of a cohort in a rural north Indian community. BMC Infect Dis 2015;15;1.
Dharmage SC, Rajapaksa LC, Fernando DN. Risk factors of acute lower respiratory tract infections in children under five years of age. Southeast Asian J Trop Med Public Health 1996;27;107–10.
Chandwani H, Pandor J. Healthcare-Seeking Behaviors of Mothers regarding their Children in a Tribal Community of Gujarat, India. Electron Physician 2015;7;990.
Jroundi I, Benmessaoud R, Mahraoui C, Moraleda C, Tligui H, Seffar M, et al. Antibiotic usage prior and during hospitalization for clinical severe pneumonia in children under five years of age in Rabat. Morocco Antibiotics 2013;2;450–64.
Md Rezal RS, Hassali MA, Alrasheedy AA, Saleem F, Md Yusof FA, Godman B. Physicians’ knowledge, perceptions and behaviour towards antibiotic prescribing: a systematic review of the literature. Exp Rev Anti-infective Ther 2015;13;665–80.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This is an open access article under the CC BY-NC license (http://creativecommons.org/licences/by-nc/4.0/).
About this article
Cite this article
Shaheen, M.H., Siddiqui, M.I., Jokhdar, H.A. et al. Prescribing Patterns for Acute Respiratory Infections in Children in Primary Health Care Centers, Makkah Al Mukarramah, Saudi Arabia. J Epidemiol Glob Health 8, 149–153 (2018). https://doi.org/10.2991/j.jegh.2017.10.007
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2991/j.jegh.2017.10.007