Antimicrobial Drug Prescription Patterns for Respiratory Tract Infections in Military Hospitals Lagos Nigeria.
https://doi.org/10.51412/psnnjp.2022.28
Keywords:
Prescription patterns, Respiratory tract infections, AntimicrobialsAbstract
Background: Antibiotics are powerful and effective medicines used for treating infections caused by bacteria. Of all the challenges faced due to antibiotics abuse, the greatest is antibiotic resistance. A major cause of antibiotic resistance is the wrong use of antibiotics in the management of diseases not caused by bacteria.Antibiotics are irrationally used in the treatment of viral infections as seen in many cases of respiratory tract infections. This study aims to evaluate the frequency of various RTIs, the
management and factors that influence antimicrobial prescription patterns for various RTIs in Military Hospital Lagos, Lagos State, Nigeria.
Methods: A cross-sectional study was conducted in Military Hospital Lagos where Data was obtained, using two designs of questionnaires, from prescribers and patient records. The target population was all patients treated for RTIs within a period of seven years and all prescribers who had treated patients for RTIs in Military Hospital Lagos. Post-Hoc Power Analysis with Dichotomous Endpoint was utilized in obtaining the sample size. Reliability tests of the instruments was obtained using Cronbach's Alpha. This involved descriptive statistical analysis, Chi-Square test, Binary Logistic regression analysis. The data used in the study were obtained from 209 patient records and 30 physicians.
Results: In this study, it was observed that 196(93.8%) patients admitted at Military Hospital Lagos for RTI presented with Upper Respiratory Tract Infections (URTIs; cough, common cold, pharyngitis, tonsillitis), 11(5.3%) with Lower respiratory tract infections (LRTIs; pneumonia and bronchitis) and2(0.9) with COVID. Young patients<45years (125) made up about 60% of the admissions. RTIs were more prevalent in females (111, 53.1%) than in males (98, 46.9%). It was observed that 21 (70%) physicians followed the Standard Treatment Guidelines (STG) in prescribing antibiotics for RTIs, 11(36.7%) physicians modelled their choice of antimicrobials after the senior consultants, 4(13.3%) on sensitivity results, 1(3.3%) on period preferences and 3(10%) on other factors. Out of 209 patients' records sampled, only 6(3%) patients underwent tests as ordered by their physicians before antibiotics
were prescribed even though 21(70%) physicians claimed to follow the STG. Results of the laboratory investigation ordered implicated 6 individual organisms: Gram negative cocci, Enterobacter cloacae, E. coli, SARS CoV-2, Streptomyces pyogenes and Staphylococcus species.
Conclusion: The gender of patient, physician educational qualification, observation of RTIs and frequency of RTIs significantly influence the antimicrobial prescription pattern for various RTIs in Military Hospital Lagos. In order to increase prescription quality, improve the rationality of drug use and reduce the prevalence of antibiotic resistance, we recommend the development of targeted intervention programs including but not limited to continuous enlightenment of physicians on strict compliance to the guidelines in the management of RTIs.
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