Introduction:
Antibiotics are among the most commonly prescribed drugs in the hospital setting.
Because of an overall rise in health care costs, lack of uniformity in drug prescribing and
the emergence of antibiotic resistance, monitoring and control of antibiotic use are of
growing concern and strict antibiotic policies and prescribing guidelines are warranted.
The aim of the study was to monitor the antibiotic prescriptions in a general outpatient
setting in a rural regional hospital in Mpumalanga and to determine the impact of an
education intervention on the prescribing patterns and adherences to the EDL/STD
Method:
Randomly selected adult outpatients files, at Themba Hospital, Mpumalanga, were
selected to review the antibiotic prescribing patterns. The antibiotic prescriptions,
diagnosis or symptom complex, and category of prescriber were recorded. The antibiotic
prescriptions were cost according to the 2007 Hospital price list. Prescriptions were
recorded in two phases; Phase 1; September, October and November 2006 and again
January, February and March 2007 for Phase 2. Lectures on antibiotic prescribing, the
use of the EDL/STG and the risk of antibiotic resistance were provided to all medical
doctors in the first two weeks of January 2007. The prescription patterns, compliance with
EDL/STG and the cost of the pre and post lectures were compared.
Results:
During the six-month study, a total of 1021 (Phase 1 = 505; Phase 2 = 520) prescriptions
were reviewed and of those, 368 [Phase 1 = 230(46%); Phase 2 = 138 (27%)]
prescriptions contained one or more antibiotics. Although the total number of antibiotics
prescribed decreased from 338 in Phase 1 to 172 in Phase 2 the non-adherent to the
EDL/STD for each antibiotic for the different diagnoses increased from 90% to 98% in
Phases 1 and 2 respectively. There was no improvement in non-adherent prescriptions
from the Community Medical Officers (CMO) and the Medical Interns after the lecture. The
total antibiotic cost for the study period was R4 235.29 the calculated cost as per STG for
the different diagnoses was R1 485.02 a decrease of 285%
Conclusion:
The number of prescriptions with antibiotics and the number of antibiotics decreased after
the lecture. The antibiotics were not prescribed according to the EDL/STD. The lectures
ix
had no impact on the EDL/STG adherence. The EDL/STG should be included in the
teaching and learning of medical students as the junior staff prescribed the most nonadherent
antibiotic prescriptions and a once off in-service lecture had little impact.
Prescribing according to the STG could have a significant impact in decreasing the cost of
antibiotics.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/397 |
| Date | January 2010 |
| Creators | Danysz, Karolina Z |
| Contributors | Gous, AGS |
| Publisher | University of Limpopo (Medunsa) |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | ix 47p, ill |
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