Antibiotic prescription for adults with upper respiratory tract infection and acute bronchitis at King Chulalongkorn Memorial Hospital, Thailand

作者：Issarachaikul Ratima; Suankratay Chusana^*

来源：Asian Biomedicine, 2013, 7(1): 15-20.

DOI：10.5372/1905-7415.0701.146

• Acute respiratory tract infection
• acute bronchitis
• antibiotic
• antibiotic prescription
• Thailand

Background: Inappropriate use of antibiotics for upper respiratory tract infection (URI) and acute bronchitis frequently observed among patients in the outpatient department (OPD) can lead to increased rates of antibiotic-resistant bacteria and an unnecessary increase in cost of treatment. At the OPD of the King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, the majority of antibiotics are prescribed by general practitioners and residents for patients with URI and acute bronchitis. %26lt;br%26gt;Objective: To determine physician practices in prescribing antibiotics for adult patients with URI and acute bronchitis attending a major urban OPD. %26lt;br%26gt;Material and Methods: This is a descriptive study of 379 cases involving adult patients with URI and acute bronchitis attending the OPD of KCMH from 1 October to 31 December 2010. %26lt;br%26gt;Results: Of the 379 study patients, 126 (33.2%) were males and 253 (66.8%) females; the mean age was 42.5 +/- 16.1 years. There were 339 (89.4%) and 40 (10.6%) patients with URI and acute bronchitis, respectively. Of339 patients with URI, there were 171 (50.4%) URI of multiple and unspecified sites, 91(26.8%) with pharyngitis, 32(9.4%) with nasopharyngitis, 19 (5.6%) with sinusitis, 14(4.13%) tonsillitis, and 12(3.5%) patients with rhinitis. One hundred and sixty-seven (44.1%) patients were treated by residents and 212 (55.9%) by faculty staff. Antibiotics were prescribed for 81.3% of cases; the rates were 73.7% by residents and 87.7% by faculty staff. The most commonly prescribed antibiotic was amoxicillin (127 patients, 41.2%), followed by amoxicillin/clavulanic acid (86 patients, 27.9%), and roxithromycin (60 patients, 19.5%). According to the multivariate analysis, the factors contributing to antibiotic prescription included the presence of sore throat, abnormal lung signs, and examination and treatment by non-Medicine residents and staffs. %26lt;br%26gt;Conclusions: There is a very high rate of overuse of antibiotics for URI and acute bronchitis in our institute. Interventions to reduce the overuse of antibiotics are urgently needed.

• 出版日期2013-2