Faculty of Medicine, Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda.
Faculty of Health Sciences, Department of Paediatrics and Child Health, Lira University, Lira, Uganda.
PLoS One. 2020 Dec 28;15(12):e0243868. doi: 10.1371/journal.pone.0243868. eCollection 2020.
Rational use of medicines requires that patients receive medications appropriate to their clinical needs. Irrational prescription of antibiotics has been reported in many health systems across the world. In Uganda, mainly nurses and assistant medical officers (Clinical officers) prescribe for children at level III and IV primary care facilities (health center II and IV). Nurses are not primarily trained prescribers; their antibiotic prescription maybe associated with errors. There is a need to understand the practices of antibiotic prescription among prescribers in the public primary care facilities. We therefore determined antibiotic prescription practices of prescribers for children under five years at health center III and IV in Mbarara district, South Western Uganda.
This was a retrospective descriptive cross-sectional study. We reviewed outpatient records of children <5 years of age retrospectively. Information obtained from the outpatient registers were captured in predesigned data abstraction form. Health care providers working at health centers III and IV were interviewed using a structured questionnaire. They provided information on socio-demographic, health facility, antibiotic prescription practices and availability of reference tools. Data was analyzed using STATA software version 13∙0.
There were 1218 outpatients records of children under five years reviewed and 35 health care providers interviewed. The most common childhood illness diagnosed was upper respiratory tract infection. It received the most antibiotic prescription (53%). The most commonly prescribed oral antibiotics were cotrimoxazole and amoxicillin, and ceftriaxone and benzyl penicillin were the commonest prescribed injectable antibiotics. Up to 68.4% of the antibiotic prescription was irrational. No prescriber or facility factors were associated with irrational antibiotic prescription practices.
Upper respiratory tract infection is the most diagnosed condition in children under five years with Cotrimoxazole and Amoxicillin being the most commonly prescribed antibiotics. Antibiotics are being prescribed irrationally at health centers III and IV in Mbarara District. Training and support supervision of prescribers at health centers III and IV in Mbarara district need to be prioritized by the district health team.
合理用药要求患者使用符合其临床需求的药物。在世界范围内的许多卫生系统中，都有报告称抗生素的处方存在不合理现象。在乌干达，主要是护士和助理医疗官（临床医生）在三级和四级初级保健机构（卫生中心 II 和 IV）为儿童开处方。护士并非主要的培训处方开具者；他们的抗生素处方可能存在错误。因此，有必要了解初级保健机构中处方开具者的抗生素处方实践。我们确定了在乌干达西南部姆巴拉拉地区三级和四级卫生中心的五岁以下儿童的抗生素处方实践。
这是一项回顾性描述性横断面研究。我们回顾性地审查了 5 岁以下儿童的门诊记录。从门诊登记簿中获取的信息被捕获在预先设计的数据提取表中。使用结构化问卷采访了在卫生中心 III 和 IV 工作的卫生保健提供者。他们提供了有关社会人口统计学、卫生设施、抗生素处方实践和参考工具可用性的信息。数据使用 STATA 软件版本 13.0 进行分析。
共审查了 1218 份 5 岁以下儿童的门诊记录，并采访了 35 名卫生保健提供者。最常见的儿童疾病诊断为上呼吸道感染。它接受了最多的抗生素处方（53%）。最常开的口服抗生素是复方新诺明和阿莫西林，最常开的注射用抗生素是头孢曲松和苄青霉素。多达 68.4%的抗生素处方是不合理的。没有发现处方开具者或医疗机构因素与不合理的抗生素处方实践有关。
上呼吸道感染是 5 岁以下儿童最常见的疾病，复方新诺明和阿莫西林是最常开的抗生素。在姆巴拉拉区的三级和四级卫生中心，抗生素的使用存在不合理现象。姆巴拉拉区的三级和四级卫生中心的处方开具者需要接受培训和支持监督，这应成为地区卫生团队的优先事项。
