Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital: a pilot study and the implications

S Nakwatumbah, D Kibuule, B Godman, V Haakuria, F Kalemeera, A Baker, M Mwangana

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective is to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. Methods: Descriptive observational cross-sectional study. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG). Results: The majority of prescriptions (62%) complied with the NSTGs; however, lower than national targets (95%). Most prescriptions were empiric and prescribers typically made reference to the NSTG (58%). Diagnosed infections were principally respiratory infections (58%) and penicillins were the most used antibiotics. Good concurrence between signs and symptoms with the diagnosis; diagnosis of upper respiratory tract, oral-dental and urogenital infections with prescribing of penicillins. Combination antibiotics and amphenicols were independent predictors of compliance to the NSTGs. The main behaviours associated with antibiotic prescribing were patient influences, clinical state, and access to guidelines. Conclusions: Compliance to NSTGs is suboptimal. Prescribing of combination antibiotics, penicillins and diagnosis of oral dental, genitourinary and ear, nose and throat infections were important predictors for NSTG compliance. There is a need to implement antibiotic indicators and stewardship programmes, and ensure access to NSTGs, to improve future antibiotic prescribing in Namibia.
LanguageEnglish
Pages713-721
Number of pages9
JournalExpert Review of Anti-infective Therapy
Volume15
Issue number7
Early online date5 May 2017
DOIs
Publication statusPublished - 31 Jul 2017

Fingerprint

Namibia
Referral and Consultation
Guidelines
Anti-Bacterial Agents
Infection
Penicillins
Prescriptions
Tooth
Oral Diagnosis
Pharynx
Nose
Respiratory Tract Infections
Respiratory System
Compliance
Signs and Symptoms
Ear
Patient Care
Therapeutics
Public Health
Cross-Sectional Studies

Keywords

  • antibiotics
  • Namibia
  • prescribing
  • Namibia Standard Treatment Guidelines
  • penicillin
  • patient influences
  • clinical state
  • access to guidelines

Cite this

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title = "Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital: a pilot study and the implications",
abstract = "Background: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective is to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. Methods: Descriptive observational cross-sectional study. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG). Results: The majority of prescriptions (62{\%}) complied with the NSTGs; however, lower than national targets (95{\%}). Most prescriptions were empiric and prescribers typically made reference to the NSTG (58{\%}). Diagnosed infections were principally respiratory infections (58{\%}) and penicillins were the most used antibiotics. Good concurrence between signs and symptoms with the diagnosis; diagnosis of upper respiratory tract, oral-dental and urogenital infections with prescribing of penicillins. Combination antibiotics and amphenicols were independent predictors of compliance to the NSTGs. The main behaviours associated with antibiotic prescribing were patient influences, clinical state, and access to guidelines. Conclusions: Compliance to NSTGs is suboptimal. Prescribing of combination antibiotics, penicillins and diagnosis of oral dental, genitourinary and ear, nose and throat infections were important predictors for NSTG compliance. There is a need to implement antibiotic indicators and stewardship programmes, and ensure access to NSTGs, to improve future antibiotic prescribing in Namibia.",
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Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital : a pilot study and the implications. / Nakwatumbah, S; Kibuule, D; Godman, B; Haakuria, V; Kalemeera, F; Baker, A; Mwangana, M.

In: Expert Review of Anti-infective Therapy, Vol. 15, No. 7, 31.07.2017, p. 713-721.

Research output: Contribution to journalArticle

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N2 - Background: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective is to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. Methods: Descriptive observational cross-sectional study. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG). Results: The majority of prescriptions (62%) complied with the NSTGs; however, lower than national targets (95%). Most prescriptions were empiric and prescribers typically made reference to the NSTG (58%). Diagnosed infections were principally respiratory infections (58%) and penicillins were the most used antibiotics. Good concurrence between signs and symptoms with the diagnosis; diagnosis of upper respiratory tract, oral-dental and urogenital infections with prescribing of penicillins. Combination antibiotics and amphenicols were independent predictors of compliance to the NSTGs. The main behaviours associated with antibiotic prescribing were patient influences, clinical state, and access to guidelines. Conclusions: Compliance to NSTGs is suboptimal. Prescribing of combination antibiotics, penicillins and diagnosis of oral dental, genitourinary and ear, nose and throat infections were important predictors for NSTG compliance. There is a need to implement antibiotic indicators and stewardship programmes, and ensure access to NSTGs, to improve future antibiotic prescribing in Namibia.

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