Highlights
- •Prescribing of Watch-group antibiotics was evidently high and requires close monitoring.
- •Second-generation cephalosporins and macrolides were the frequently prescribed Watch-group antibiotics.
- •Antibiotic prescribing practice was inappropriate and adherence to clinical guidelines was poor.
Abstract
Background
The 2019 WHO Access, Watch, Reserve (AWaRe) classification antibiotic classification
framework aims to prevent irrational prescribing of antibiotics used to treat widespread
infections. This study explored antibiotic prescribing pattern for appropriate indications
by family physicians and general dentists in primary healthcare practices.
Methods
A retrospective review of patients’ electronic medical records was conducted over
six months, from May 1, 2020, to November 30, 2020. The data were collected from 24
general family medicine and dental practices within the North West Armed Forces in
Tabuk city. Antibiotic prescribing for systemic use (J01) was assessed by the number
of prescriptions and the number defined daily doses (DDDs) and then analyzed according
to the AWaRe classification. The prescribing of antibiotics for appropriate indications
was assessed through comparing the prescription pattern with the recently published
and relevant clinical guidelines. Multivariate logistic regression analysis was used
to predict the association between the prescribing of AWaRe category and some demographic
and disease-related factors.
Results
In total, 752 prescriptions of antibiotics were collected. Watch-group antibiotics
such as second-generation cephalosporin and macrolide were more likely prescribed
(51.1%) based on the number of prescriptions and (52.2 %) based on DDDs compared with
Access-group antibiotics (48.9%) and (47.8%), respectively. The percentages of Watch
group antibiotics for children and adults were 66.7% and 42.9%, respectively. Adherence
to prescribing guidelines was poor for children (27.2%) and adults (64%). Being a
child (adjusted OR: 2.89; 95% CI = 1.46–5.78), diagnosis with acute respiratory tract
infection (adjusted OR, 2.62; 95% CI = 1.03–6.69), and urinary tract infection (adjusted
OR, 4.69; 95% CI = 2.09–10.56) were associated with higher prescriptions of Watch-group
antibiotics.
Conclusion
a higher prescribing of Watch-group antibiotics and poor adherence to antibiotic guidelines
were observed, especially for children. The findings of this study identified targets
for further improvement and interventions needed to develop better antibiotic-prescribing
practices.
Keywords
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