Antimicrobial prescribing patterns for respiratory diseases including tuberculosis in Russia: a possible role in drug resistance?
J Antimicrob Chemother
; 54(3): 673-9, 2004 Sep.
Article
em En
| MEDLINE
| ID: mdl-15317742
ABSTRACT
BACKGROUND:
Inappropriate antibiotic prescribing exposes patients to the risk of side effects and encourages the development of drug resistance across antimicrobial groups used for respiratory infections including tuberculosis (TB).AIM:
Determine among Russian general practitioners and specialists (1) sources of antimicrobial prescribing information; (2) patterns of antimicrobial prescribing for common respiratory diseases and differences between primary and specialist physicians; (3) whether drug resistance in TB might be linked to over-prescribing of anti-TB drugs for respiratory conditions.METHODS:
Point-prevalence cross-sectional survey involving all 28 primary care, general medicine and TB treatment institutions in Samara City, Russian Federation. In this two-stage study, a questionnaire was used to examine doctors' antimicrobial (including TB drugs) prescribing habits, sources of prescribing information, management of respiratory infections and a case scenario ('common cold'). This was followed by a case note review of actual prescribing for consecutive patients with respiratory diseases at three institutions.RESULTS:
Initial questionnaires were completed by 81.3% (425/523) of physicians with 78.4% working in primary care. Most doctors used standard textbooks to guide their antimicrobial practice but 80% made extensive use of pharmaceutical company information. A minority of 1.7% would have inappropriately prescribed antibiotics for the case and 0.8-1.8% of respondents would have definitely prescribed TB drugs for non-TB conditions. Of the 495 respiratory cases, 25% of doctors prescribed an antibiotic for a simple upper respiratory tract infection and of 8 patients with a clinical diagnosis of TB, 4 received rifampicin monotherapy alone. Ciprofloxacin was widely but inappropriately used.CONCLUSION:
Doctors rely on information provided by pharmaceutical companies; there was inappropriate antibiotic prescribing.
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Base de dados:
MEDLINE
Assunto principal:
Prescrições de Medicamentos
/
Doenças Respiratórias
/
Tuberculose
/
Farmacorresistência Bacteriana
/
Antibacterianos
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Humans
País como assunto:
Asia
/
Europa
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article