Antimicrobial prescribing trends in primary care: implications for health policy in Bahrain.

ABSTRACT

PURPOSE: To evaluate antimicrobial prescribing pattern by primary care physicians. METHODS: A nation-wide, retrospective, multi-centric prescription-audit was carried out in primary care health centres in Bahrain. RESULTS: Systemic antimicrobials ranked the fourth most common class of drugs prescribed. Amoxycillin, cephalexin, erythromycin, ciprofloxacin and cotrimoxazole were prescribed by general practitioners (GPs) more often than by family physicians (FPs) (p < 0.05). With respect to prescribing of other antimicrobials and anthelmintic mebendazole, the differences between GPs and FPs were nonsignificant. Seventy-seven per cent of systemic antimicrobials prescribed were for respiratory tract infections (RTIs). Topical antimicrobial preparations for ear and eye infections were prescribed by GPs in a rate significantly higher than by FPs (p < 0.05); of these, chloramphenicol and Locacorten vioform (flumethasone + clioquinol) ear drops and sulphacetamide eye drops were more often prescribed by GPs (p < 0.05). There were no significant differences in prescribing between GPs and FPs as regards topical antimicrobials used for oropharyngeal, skin and vulvovaginal infections. CONCLUSION: Antimicrobials were extensively used in primary care, mainly for treating RTIs. The general practitioners were more avid prescribers of antimicrobials compared to the FPs. Rational use of antimicrobials in primary care should be encouraged and the reasons for the observed differences in prescribing of antimicrobials between the GPs and FPs need further evaluation.