Kho B P, Ong C M Y, Tan F T Y, Wee C Y
Hospital Simunjan, Pharmacy, Jalan Gunung Ngeli, Simunjan, Sarawak 94800, Malaysia.
Med J Malaysia. 2013 Apr;68(2):136-40.
Upper respiratory tract infection (URTI) is mostly viral in aetiology, but patients presenting with such complaints are frequently prescribed antibiotics. This may result in increased development of antimicrobial resistance. The objectives of this study are to determine the choice and proportion of oral antibiotics prescribed in patients with URTI, in a Sarawak district hospital setting. All outpatient prescriptions received in July 2011 in 10 hospitals with relevant diagnoses were analysed. A total of 6747 URTI prescriptions met the inclusion criteria, and 64.8% (95% CI 63.7%, 65.9%) had antibiotic prescribed. Medical Assistants (MAs) were significantly more likely to prescribe antibiotics compared to Medical Officers (MOs) (p < 0.001). Prescribers were significantly influenced by the patient's age and specific diagnosis when prescribing antibiotics for URTI (p < 0.001). Antibiotic choices differed between MOs and MAs, where some of the antibiotic choices were inappropriate. There is a need for multi-faceted interventions to improve antibiotic prescribing rate and choice.
上呼吸道感染（URTI）的病因大多为病毒感染，但出现此类症状的患者经常被开具抗生素。这可能会导致抗菌药物耐药性增加。本研究的目的是确定在砂拉越地区医院环境中，为上呼吸道感染患者开具口服抗生素的选择和比例。对2011年7月在10家医院收到的所有具有相关诊断的门诊处方进行了分析。共有6747份上呼吸道感染处方符合纳入标准，其中64.8%（95%可信区间63.7%，65.9%）开具了抗生素。与医务人员（MOs）相比，医疗助理（MAs）开具抗生素的可能性显著更高（p<0.001）。在为上呼吸道感染患者开具抗生素时，开处方者受到患者年龄和具体诊断的显著影响（p<0.001）。医务人员和医疗助理的抗生素选择不同，其中一些抗生素选择并不恰当。需要采取多方面的干预措施来提高抗生素的开具率和选择的合理性。
