Antibiotic-Prescribing Patterns Among Patients With Respiratory Symptoms in the Eastern Province, Kingdom of Saudi Arabia.

Autor:	Al-Baghli NA; Public Health Administration, Dammam Health Network, Dammam, SAU., Al Saif AZ; Keep Well, Model of Care, Eastern Health Cluster, Dammam, SAU., Al Dorazi SA; Public Health Administration, Dammam Health Network, Dammam, SAU., Zainaldeen MH; Directorate of Infection Prevention and Control, General Directorate of Health Affairs in Eastern Province, Dammam, SAU., Alameer AH; Dentistry, Dammam Health Network, Dammam, SAU., Albaghli S; Pathology and Laboratory Medicine, King Saud Medical City, Riyadh, SAU., Al-Dawood AM; Family Medicine, Dammam Health Network, Dammam, SAU., Buhelaiga SM; Family Medicine, Dammam Health Network, Dammam, SAU., Alsalim BS; Family Medicine, Dammam Health Network, Dammam, SAU., Rabaan AA; Molecular Microbiology, Johns Hopkins Aramco Healthcare, Dhahran, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Aug 28; Vol. 15 (8), pp. e44298. Date of Electronic Publication: 2023 Aug 28 (Print Publication: 2023).
DOI:	10.7759/cureus.44298
Abstrakt:	Background Upper respiratory tract infections (URTIs) represent the most common diagnosis in ambulatory care settings. Some of these infections are properly treated with antibiotics, but evidence points to an inappropriate overuse of antibiotics in URTI management. This overuse is linked to antibiotic resistance, drug-related adverse effects, and increased costs. Objective This study evaluated the prevalence and predictors of antibiotic prescription for patients with URTI symptoms at the primary healthcare centers (PHCCs) and pediatric emergency department (ED) of the Maternity and Children Hospital (MCH) in Dammam, Saudi Arabia. Methods A prospective study was conducted in the PHCCs and pediatric ED of MCH. Trained physicians collected data on patients with URTI symptoms aged three years and older. Scores based on modified Centor criteria were calculated, and rapid antigen detection tests (RADTs) were conducted for all study participants. Results Out of 469 patients with a URTI, 141 (30.1%) received a prescription for an antibiotic, with a smaller proportion in the PHCCs (n=85; 24.4%) than in the pediatric ED (n=56; 46.3%). The main significant predictors of antibiotic prescription in terms of odds ratio (OR) and 95% confidence interval (95%CI) were a positive RADT result (OR=41.75, 95%CI=4.76-366.28), the presence of tonsillar exudate (OR=5.066, 95%CI=3.08-8.33), tender and/or swollen anterior cervical lymph nodes (OR=4.537, 95%CI=1.96-10.54), and fever (OR=3.519, 95%CI=2.33-5.31). A higher Centor score was also a predictor (2 to 5 vs. -1 to 1) (OR=2.72, 95%CI=1.8-4.12). The absence of a cough was not a significant predictor (OR=1.13, 95%CI=0.74-1.72). Conclusions Although a positive RADT increased the likelihood that a patient would be prescribed an antibiotic at the time of assessment, most antibiotic prescriptions were not justified. To control expenses, prevent adverse effects, and limit the spread of antibiotic resistance, efforts should be made to reduce unnecessarily high antibiotic usage. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Al-baghli et al.)
Databáze:	MEDLINE
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