Antibiotic prescription for febrile outpatients: a health facility-based secondary data analysis for the Greater Accra region of Ghana.
Antibiotic prescription for febrile outpatients: a health facility-based secondary data analysis for the Greater Accra region of Ghana.
复制标题
高热门诊病人的抗生素处方：加纳大阿克拉地区的基于医疗机构的二级数据分析。
DOI：
10.1186/s12913-020-05771-9
复制
发表时间：
2020-10-27
影响因子：
2.8
通讯作者：
Koram KA
中科院分区：
文献类型：
--
作者：
Opoku MM;Bonful HA;Koram KA
Misguided prescription of antibiotics is an important contributor towards the emergence and spread of antibiotic resistance. The absence of effective interventions to control antibiotic use leads to increased consumption beyond the needed requirements. Antibiotic stewardship interventions must be appropriately targeted and assessed to enhance the controlled use of antibiotics. The objective of this study was to determine the factors associated with antibiotic prescription to febrile outpatients who seek care in health facilities within the Greater Accra region of Ghana. Secondary data obtained from the medical records of 2519 febrile outpatients, consecutively sampled at the outpatient department of 6 health facilities in 3 municipalities during the baseline survey of a quasi-experiment in 2015 was used. The primary outcome was prescription of any antibiotic. Independent variables included patients’ demographics, symptoms, laboratory investigations (blood film microscopy, malaria rapid diagnostic test, full blood count, urine and stool routine examinations), diagnoses, and prescribers’ demographics. Crude and adjusted logistic regression analyses were used to determine the factors associated with antibiotic prescription. The prevalence of antibiotic prescription was 70.1% (95% CI: 67.7–72.4). Prescribers with more years of practice (> 5 years) were more likely to prescribe antibiotics compared to those with less than 3 years of practice (p < 0.001). Integrated Management of Neonatal and Childhood Illnesses (IMNCI) training was associated with a 2.3 (95% CI: 1.54, 3.53, p < 0.001) fold odds of antibiotic prescribing. Patients aged 5 years or more were 60% less likely to receive antibiotics compared with those under 5 years (AOR = 0.40, 95% CI: 0.32, 0.51; p < 0.001). Patients referred for laboratory investigations were 29% less likely to be prescribed antibiotics than those not referred. The presence of cough as a presenting symptom was associated with a 3.5 (95% CI: 2.54, 4.92) fold odds of antibiotic prescription. Prescription of antibiotics to febrile outpatients was high. Promoting laboratory testing can potentially reduce irrational antibiotic prescription. Prescribing antibiotics for children under five and the prescribing practices of prescribers with longer years of practice should be targeted with interventions to reduce high use of antibiotics.
登录
查看更多内容
影响因子：
1.7
作者：
Anderson, Hayley;Vuillermin, Peter;Burgner, David
通讯作者：
Burgner, David
影响因子：
158.5
作者：
D'Acremont, Valerie;Kilowoko, Mary;Genton, Blaise
通讯作者：
Genton, Blaise
影响因子：
4.9
作者：
Hsu, Li-Yang;Tan, Thean-Yen;Koh, Tse-Hsien
通讯作者：
Koh, Tse-Hsien
患有社区获得性肺炎的成年人的病毒感染：患病率，病原体和表现。
影响因子：
9.6
作者：
Johnstone J;Majumdar SR;Fox JD;Marrie TJ
通讯作者：
Marrie TJ
影响因子：
3.7
作者：
Bell BG;Schellevis F;Stobberingh E;Goossens H;Pringle M
通讯作者：
Pringle M