Unnecessary antimicrobial prescribing for upper respiratory tract infections in children in Pietermaritzburg, South Africa.

Lehlohonolo John Mathibe,Nonhle Perseverance Zwane

doi:10.4314/ahs.v20i3.15

Abstract

Acute upper respiratory tract infections (URTIs) are contagious diseases of the upper airways, but they are self-limiting in nature. Therefore, antimicrobial-use for the majority of the URTIs is considered inappropriate. Unfortunately, globally, antimicrobials are still being prescribed for the treatment of URTIs, especially in children. However, there is insufficient evidence on the causes of this phenomenon in South Africa. To investigate whether the parents/guardians accompanying children with URTIs expected/influenced physicians and/or nurses to prescribe antibiotics. This was a prospective descriptive and explorative questionnaire-based study. Participants were guardians who accompanied children aged five years and below, diagnosed with acute URTIs. Three hundred and six parents/guardians participated in this study. Seventy six percent (n=233) of participants received antibiotics for URTIs for their children, and 67% (n=156) of these did not make requests for antimicrobial therapy. On overall, there was a statistically significant (p < 0.0001) chance (with OR of 5.9; 95% CI, 2.4 - 14.2) for receiving antibiotics for URTIs without a request. Physicians and other healthcare providers need education on rational prescribing of antimicrobials, and to implement evidence-based standard treatment guidelines, to reduce inappropriate use of antibiotics in children with self-limiting URTIs.

Highlights

Acute upper respiratory tract infections (URTIs) are contagious diseases of the upper airways, but they are self-limiting in nature
At the beginning of this study, the researchers hypothesised that the parents/guardians were at the centre of unnecessary prescribing of antibiotics for children with URTI
The findings of this research suggest that it is the majority of the prescribers, and not the parents/guardians, who are likely to exacerbate the challenge of multi-drug resistance due to irrational prescribing patterns

Summary

Introduction

Acute upper respiratory tract infections (URTIs) are contagious diseases of the upper airways, but they are self-limiting in nature. Conclusion: Physicians and other healthcare providers need education on rational prescribing of antimicrobials, and to implement evidence-based standard treatment guidelines, to reduce inappropriate use of antibiotics in children with self-limiting URTIs. Keywords: Antibiotics, antimicrobials, prescribing, upper respiratory tract infections, children. Unnecessary antimicrobial prescribing for upper respiratory tract infections in children in Pietermaritzburg, South Africa. Antibiotics have changed the world and saved millions of lives.[1,2] Infectious diseases which used to kill many people in the past, can be cured These medicines are relatively safe compared to many other drugs which cause serious side effects.[3] irrational/inappropriate or even unnecessary prescribing weaken the most powerful “weapons” available to all healthcare professionals in the fight against life-threatening infections.

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Discussion

Conclusion