The commonest prescribed group of drugs is antimicrobials. Various studies have shown that
they are overused globally. Since Primary health care represents the first tier of the health
care system, evaluation of antimicrobial use in primary health w e settings is a necessity to
ensure rational and cost-effective use of these agents in the treatment of infectious diseases.
It has been reported by Hooton and Levy (2001 : 1088) that 20% to 50% of antimicrobials are
inappropriately used in developing countries. According to Rebana et al. (1998: 175) the
increasing overuse of antimicrobials has resulted in an enormous escalation in the total costs
of drugs contributing to 15% to 30 % of the total health budget. Hooton and Levy
(2001: 1087) reported in a study that inappropriate use and overuse of antimicrobials are risk
factors for the emergence of antibiotic resistant bacteria. There is a high incidence of
infectious diseases in developing countries that are due to the rapid spread of resistant strains
through over-crowding, poor sanitation and unsafe sexual practices (Liu et al., 1999: 540).
The general objective of the study was the analysis and interpretation of the usage and related
costs of antimicrobial prescriptions in a private primary health w e setting in South Africa.
The study is a non-experimental, quantitative, retrospective drug utilisation review of
antimicrobial usage in a private primary health care setting. Data were obtained from the
central database of a private primary health care service provider. Data of nine randomly
selected clinics, situated in different geographical areas of South Africa, were extracted for
the period 1st January to 31st December 2001. The study population was made of the total
patient population of patients using antimicrobials during this one year period.
Antimicrobial usage was analysed according to: number of patients, age and gender
distribution, diagnosis, pharmacological groups.
The total number of patients who visited the nine clinics during the year was 83 655 of which
59.50% were females and 40.22% males. In 0.28% of the cases gender was not indicated.
Patients in age groups 6 (20-40 years) and 7 (40-60 years) accounted for the highest number
of patients (66.31%, n = 54 964). A total of 515 976 medicine items costing R1 716 318.90
were prescribed, of these, 18.69%, (N=96 423) were antimicrobials costing 60.89%, (R1 045
108.00). Of the total number of patients that visited the nine clinics, 65.34% (N=54 663) were
prescribed antimicrobials. The total number of diagnoses (140 723) where antimicrobials
were prescribed accounted for 68.52% (N46 42 1).
The highest number of antimicrobial prescriptions according to pharmacological and age
groups were: penicillins followed by sulphonamides and tetracyclines. The diagnoses with the
highest number of antimicrobial prescriptions were the respiratory tract infections (viral
influenza, acute bronchitis and upper respiratory tract infection) and pelvic inflammatory
disease
The prescribing of antimicrobials in respiratory tract infections could indicate overuse and
inappropriate use of these drugs. Because most of these infections are caused by viruses or
other non-bacterial agents, are self limiting. Therefore, the use of antibiotics courses is neither
necessary nor appropriate in these conditions. The overuse and inappropriate use of such
drugs have an effect on the health of the patients needing cure, and the general budget on
health care service. It is recommended that further studies are conducted on antimicrobial
prescribing and use. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nwu/oai:dspace.nwu.ac.za:10394/720 |
| Date | January 2005 |
| Creators | Katende-Kyenda, Norah Lucky |
| Publisher | North-West University |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
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