Antibiotic Prescribing Pattern in Primary Care Practice in Federal Territory Kuala Lumpur and Putrajaya, Malaysia

Abstract

Introduction: The emerging of antibiotic resistance has become a challenge to global health and there is a strong association between antibiotic consumption and incidence of resistance. One of the tools to monitor and identify antibiotic prescribing pattern is Point Prevalence Survey (PPS). Objectives: To determine the pattern of antibiotic prescribing in Primary Health Clinics (PHC) in Federal Territory Kuala Lumpur and Putrajaya (FTKLP). Methods: A cross-sectional study was conducted at 17 PHCs in FTKLP using universal sampling. Data from prescriptions received were recorded in PPS-PC data collection form. The compliance of the antibiotics prescribed were determined via cross-referencing with the Malaysian National Antibiotic Guideline (NAG) 2014 and/or Clinical Pathway for Antimicrobial Stewardship Program in PHCs (CP) 2019. Results: A total of 338 prescriptions with antibiotics were received and the prescribing rate of antibiotics at the PHCs in FTKLP 2019 was 5.94%.Only 128 (37.9%) prescriptions with antibiotics prescribed were compliant with either the NAG or the CP while 33 (9.8%) prescriptions were found non-compliant with either guideline. Compliance of the remaining 177 prescriptions could not be determined due to non-specific diagnoses. The most commonly prescribed drug class was penicillin (n=198, 58.4%), followed by cephalosporins (n=80, 23.6%) and macrolides (n=41, 12%). Conclusion: This PPS study showed a low compliance of antibiotic prescribing to guidelines compared to recent studies and indicate the need for further action to be taken in order to improve antimicrobial prescribing in PHCs. KEYWORDS: Point prevalence survey, antibiotic, primary care