Teng C L, Achike F I, Phua K L, Norhayati Y, Nurjahan M I, Nor A H, Koh C N
Sesama Centre, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
Int J Antimicrob Agents. 2004 Nov;24(5):496-501. doi: 10.1016/j.ijantimicag.2004.06.015.
Antibiotic prescribing by primary care doctors has received renewed interest due to the continuing emergence of antibiotic resistance and the attendant cost to healthcare. We examined the antibiotic prescribing rate in relation to selected socio-demographic characteristics of the prescribers at the Seremban Health Clinic, a large public primary care clinic, designated for teaching, in the state of Negeri Sembilan, Malaysia. Data were obtained from: (1) retrospective review of prescriptions for the month of June 2002 and (2) a questionnaire survey of prescribers. A total of 10667 prescriptions were reviewed. The overall antibiotic prescribing rate was 15%; the rate (16%) was higher for the general Outpatient Department (OPD) than the 3% for the Maternal & Child Health Clinic (MCH). The antibiotic prescription rates for upper respiratory tract infection (URTI) were 26% and 16%, respectively, for the OPD and MCH. Half of all the antibiotic prescriptions were for URTI making prescribing for URTI an appropriate target for educational intervention. The URTI-specific antibiotic prescription rate did not correlate with the prescribers' intention to specialise, patient load, perceived patient's expectation for an antibiotic, or the score for knowledge of streptococcal tonsillitis. Prescribing behaviours and record-keeping practices requiring correction were identified.
由于抗生素耐药性的不断出现以及随之而来的医疗成本问题，初级保健医生的抗生素处方问题再次受到关注。我们在马来西亚森美兰州一家大型公立初级保健诊所——芙蓉健康诊所（该诊所指定用于教学），研究了抗生素处方率与开处方者选定的社会人口统计学特征之间的关系。数据来自：（1）对2002年6月处方的回顾性审查，以及（2）对开处方者的问卷调查。共审查了10667份处方。总体抗生素处方率为15%；普通门诊部（OPD）的处方率（16%）高于母婴健康诊所（MCH）的3%。OPD和MCH的上呼吸道感染（URTI）抗生素处方率分别为26%和16%。所有抗生素处方中有一半是用于治疗URTI的，这使得针对URTI的处方成为教育干预的一个合适目标。特定于URTI的抗生素处方率与开处方者的专科意向、患者数量、患者对抗生素的预期以及链球菌性扁桃体炎知识得分均无相关性。确定了需要纠正的处方行为和记录保存做法。
