Abstract
| Language | English |
|---|---|
| Pages | 713-721 |
| Number of pages | 9 |
| Journal | Expert Review of Anti-infective Therapy |
| Volume | 15 |
| Issue number | 7 |
| Early online date | 5 May 2017 |
| DOIs | |
| Publication status | Published - 31 Jul 2017 |
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Keywords
- antibiotics
- Namibia
- prescribing
- Namibia Standard Treatment Guidelines
- penicillin
- patient influences
- clinical state
- access to guidelines
Cite this
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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 journal › Article
TY - JOUR
T1 - Compliance to guidelines for the prescribing of antibiotics in acute infections at Namibia’s national referral hospital
T2 - Expert Review of Anti-infective Therapy
AU - Nakwatumbah, S
AU - Kibuule, D
AU - Godman, B
AU - Haakuria, V
AU - Kalemeera, F
AU - Baker, A
AU - Mwangana, M
N1 - The Version of Record of this manuscript has been published and is available in Expert Review of Anti-infective Therapy 2017 http://www.tandfonline.com/10.1080/14787210.2017.1320220
PY - 2017/7/31
Y1 - 2017/7/31
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.
AB - 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.
KW - antibiotics
KW - Namibia
KW - prescribing
KW - Namibia Standard Treatment Guidelines
KW - penicillin
KW - patient influences
KW - clinical state
KW - access to guidelines
UR - http://www.tandfonline.com/doi/full/10.1080/14787210.2017.1320220
U2 - 10.1080/14787210.2017.1320220
DO - 10.1080/14787210.2017.1320220
M3 - Article
VL - 15
SP - 713
EP - 721
JO - Expert Review of Anti-infective Therapy
JF - Expert Review of Anti-infective Therapy
SN - 1478-7210
IS - 7
ER -