Abstract
Objective: The study was aimed to evaluate the antibiotic prescription pattern by physicians in the area of study.Methods: This cross-sectional observational study was carried out with a self-designed standard questionnaire by manual data collection over a three months period at the Debidwar Upazila of Comilla District. The data were collected by directly interviewing the participants. Microsoft Excel 2010 was used for the analysis of the collected data.Results: Out of 242 patients, 60.74% of patients were male, 39.26% of patients were female. Majority of the patients (50%) belonged to age group 9 to 20 and in terms of profession, 53.30% were students. Among the previous disease history, hypertension (20.25%) was found at the dominant position. Common cold (28.95%) was the frequent reason for visiting doctor and ciprofloxacin was prescribed to 30.17% patients (Male: 21.90%, Female: 8.26%). Before prescribing anti-bacterial agents or any other agents, only 23.55% patients were recommended diagnostic tests and in 81.81% cases, physicians simply prescribed medicine by his/her own assumption and culture and sensitivity test was recommended and done for 18.18% patients.Conclusion: Prescription of broad-spectrum antibiotics for common cold and diarrhea, prescribing antibiotics or medicine based on presumption was the clear indications of irrational antibiotics use and inappropriate prescription pattern.
Highlights
Sir Alexander Fleming discovered penicillin in 1928 which was the commencement of antibiotic revolution and brought drastic changes in the field of modern medicine
Similar findings were observed in a number of studies conducted previously in Bangladesh, Nepal, and India [1, 15, 16,]. This is not fully understood why males were prescribed more antibiotics than females but it could be due to dominance characters of male in Bangladesh which biased medical decision and had been shown in fig. 5 and for both male and female, most commonly prescribed antibiotics were ciprofloxacin and ampicillin and this finding partially matched with another study conducted in Aden, Yemen [17]
Danish guideline on prescribing antibiotics, national health service (NHS) guideline with the Rotherham Foundation Trust referred to use of narrowspectrum antibiotics where possible [19, 20,] but our practitioners most commonly prescribed broad-spectrum antibiotics for conditions like common cold, diarrhea, skin infection etc. which led to antibiotic resistance
Summary
Sir Alexander Fleming discovered penicillin in 1928 which was the commencement of antibiotic revolution and brought drastic changes in the field of modern medicine. Antibiotics proved its effectiveness in prolonging the life expectancy [1], and it is one of the most frequently used, costly medication categories, but the inexact use of antibiotics often leads to resistance towards infections. Reasons could be the demand of antibiotic treatment to satisfy patients and not having enough understanding about the incompetence of antibiotics about viral illness, and unrestrained availability of antibiotics are leading factors [3]. A major concern in public health is the rise of antimicrobial resistance (AMR). Antimicrobial resistance leads to an increase in morbidity and mortality, cost of health care. There are several influential factors that subsist when prescribing the antibiotics. The most vital recognized factor is the infelicitous prescribing of antibiotics by the practitioners [9,10,11,12]
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