Antibiotic Prescribing Pattern in Primary Care Practice in Federal Territory Kuala Lumpur and Putrajaya, Malaysia

Antibiotic Prescribing Pattern

  • Audrey Huili Lim Centre for Clinical Outcomes Research, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia
  • Shieh Teng Wong Hospital Rehabilitasi Cheras, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
  • Soon Yew Thian Pharmaceutical Services Division, Federal Territory Kuala Lumpur and Putrajaya, Jalan Cenderasari, 50590 Kuala Lumpur, Malaysia.
  • Wan Yin Tew Setapak Heatlh Clinic, Federal Territory Kuala Lumpur and Putrajaya, Wisma Rampai Blok Pasifik, Jalan 34/26, Taman Sri Rampai, 53300 Kuala Lumpur, Malaysia.
  • Siow Yeh Chiew Hospital Tengku Ampuan Afzan, Jalan Tanah Putih, 25100 Kuantan, Pahang, India
  • Xianhui Lee Cheras District Health Office, Aras 3, Klinik Kesihatan Cheras, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia.
  • Yee Yee Hor Kuala Lumpur Heatlh Clinic, Jalan Fletcher, 53200 Kuala Lumpur, Malaysia.

Abstract

Introduction: The emerging of antibiotic resistance has become a challenge to global health and there is a strong association between antibiotic consumption and incidence of resistance. One of the tools to monitor and identify antibiotic prescribing pattern is Point Prevalence Survey (PPS). Objectives: To determine the pattern of antibiotic prescribing in Primary Health Clinics (PHC) in Federal Territory Kuala Lumpur and Putrajaya (FTKLP). Methods: A cross-sectional study was conducted at 17 PHCs in FTKLP using universal sampling. Data from prescriptions received were recorded in PPS-PC data collection form. The compliance of the antibiotics prescribed were determined via cross-referencing with the Malaysian National Antibiotic Guideline (NAG) 2014 and/or Clinical Pathway for Antimicrobial Stewardship Program in PHCs (CP) 2019. Results: A total of 338 prescriptions with antibiotics were received and the prescribing rate of antibiotics at the PHCs in FTKLP 2019 was 5.94%.Only 128 (37.9%) prescriptions with antibiotics prescribed were compliant with either the NAG or the CP while 33 (9.8%) prescriptions were found non-compliant with either guideline. Compliance of the remaining 177 prescriptions could not be determined due to non-specific diagnoses. The most commonly prescribed drug class was penicillin (n=198, 58.4%), followed by cephalosporins (n=80, 23.6%) and macrolides (n=41, 12%). Conclusion: This PPS study showed a low compliance of antibiotic prescribing to guidelines compared to recent studies and indicate the need for further action to be taken in order to improve antimicrobial prescribing in PHCs.

Keywords: Point prevalence survey, antibiotic, primary care

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References

Ab Rahman, N., Teng, C. L., & Sivasampu, S. (2016). Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia. BMC Infect Dis, 16, 208. doi:10.1186/s12879-016-1530-2
Aldeyab, M. A., Kearney, M. P., McElnay, J. C., Magee, F. A., Conlon, G., Gill, D., . . . Scott, M. G. (2011). A point prevalence survey of antibiotic prescriptions: benchmarking and patterns of use. Br J Clin Pharmacol, 71(2), 293-296. doi:10.1111/j.1365-2125.2010.03840.x
Arason, V. A., Sigurdsson, J. A., Erlendsdottir, H., Gudmundsson, S., & Kristinsson, K. G. (2006). The role of antimicrobial use in the epidemiology of resistant pneumococci: A 10-year follow up. doi:10.1089/mdr.2006.12.169
Beyer, P., & Paulin, S. (2020). Priority pathogens and the antibiotic pipeline: an update. Bulletin of the World Health Organization, 98(151), 149-228. doi:http://dx.doi.org/10.2471/BLT.20.251751
Chem, E. D., Anong, D. N., & Akoachere, J. K. T. (2018). Prescribing patterns and associated factors of antibiotic prescription in primary health care facilities of Kumbo East and Kumbo West Health Districts, North West Cameroon. PLOS ONE, 13(3), e0193353. doi:10.1371/journal.pone.0193353
Dellit, T. H., Owens, R. C., McGowan, J. E., Gerding, D. N., Weinstein, R. A., Burke, J. P., . . . Hooton, T. M. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clinical Infectious Diseases, 44(2), 159-177. doi:10.1086/510393
Drew, R. H. (2009). Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm, 15(2 Suppl), S18-23. doi:10.18553/jmcp.2009.15.s2.18
Hiramatsu, K., Hanaki, H., Ino, T., Yabuta, K., Oguri, T., & Tenover, F. C. (1997). Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother, 40(1), 135-136. doi:10.1093/jac/40.1.135
Hong, C.-Y., Lin, R. T., Tan, E. S., Chong, P.-N., Tan, Y. S., Lew, Y.-J., & Loo, L.-H. (2004). Acute respiratory symptoms in adults in general practice. Family Practice, 21(3), 317-323. doi:10.1093/fampra/cmh319
Hsia, Y., Lee, B. R., Versporten, A., Yang, Y., Bielicki, J., Jackson, C., . . . Sharland, M. (2019). Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries. Lancet Glob Health, 7(7), e861-e871. doi:10.1016/s2214-109x(19)30071-3
Maina, M., Mwaniki, P., Odira, E., Kiko, N., McKnight, J., Schultsz, C., . . . Tosas-Auguet, O. (2020). Antibiotic use in Kenyan public hospitals: Prevalence, appropriateness and link to guideline availability. International Journal of Infectious Diseases, 99, 10-18. doi:https://doi.org/10.1016/j.ijid.2020.07.084
Martínez-González, N. A., Di Gangi, S., & Pichierri, G. (2020). Time Trends and Factors Associated with Antibiotic Prescribing in Swiss Primary Care (2008 to 2020). Antibiotics (Basel), 9(11). doi:10.3390/antibiotics9110837
Organisation, W. H. (2019a). International Statistical Classification of Diseases and Related Health Problems (ICD).
Organisation, W. H. (2019b). WHO Methodology for Point Prevalence Survey on Antibiotic Use in Hospitals (pp. 102): World Health Organisation.
Owens, R. C., Jr. (2008). Antimicrobial stewardship: concepts and strategies in the 21st century. Diagn Microbiol Infect Dis, 61(1), 110-128. doi:10.1016/j.diagmicrobio.2008.02.012
Russell, A. D., Tattawasart, U., Maillard, J.-Y., & Furr, J. R. (1998). Possible Link between Bacterial Resistance and Use of Antibiotics and Biocides. Antimicrobial Agents and Chemotherapy, 42(8), 2151-2151. doi:10.1128/aac.42.8.2151
Sajari, J. (2019). Antibiotic Point Prevalence Survey (PPS) in MOH Primary Care Clinics 2019. Paper presented at the National Antimicrobial Guideline 2019 Launch.
Salleh, N. (unpublished data). Ministry of Health, Malaysia. Kuala Lumpur.
Shamsuddin, S., Akkawi, M. E., Zaidi, S. T., Ming, L. C., & Manan, M. M. (2016). Antimicrobial drug use in primary healthcare clinics: a retrospective evaluation. Int J Infect Dis, 52, 16-22. doi:10.1016/j.ijid.2016.09.013
Shively, N. R., Buehrle, D. J., Clancy, C. J., & Decker, B. K. (2018). Prevalence of Inappropriate Antibiotic Prescribing in Primary Care Clinics within a Veterans Affairs Health Care System. Antimicrobial Agents and Chemotherapy, 62(8), e00337-00318. doi:10.1128/AAC.00337-18
Sivasampu, S., Wahab, Y. F., Ong, S. M., Ismail, S. A., Goh, P. P., & Jeyaindran, S. (2016). National Medical Care Statistics (NMCS) 2014 (NCRC/HSU/2016.1). Retrieved from
Snow, V., Mottur-Pilson, C., & Gonzales, R. (2001). Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults. Ann Intern Med, 134(6), 487-489. doi:10.7326/0003-4819-134-6-200103200-00014
Sulis, G., Daniels, B., Kwan, A., Gandra, S., Daftary, A., Das, J., & Pai, M. (2020). Antibiotic overuse in the primary health care setting: a secondary data analysis of standardised patient studies from India, China and Kenya. BMJ Global Health, 5(9), e003393. doi:10.1136/bmjgh-2020-003393
Tenover, F. C. (2006). Mechanisms of antimicrobial resistance in bacteria. Am J Med, 119(6 Suppl 1), S3-10; discussion S62-70. doi:10.1016/j.amjmed.2006.03.011
Truitt, K. N., Brown, T., Lee, J. Y., & Linder, J. A. (2020). Appropriateness of Antibiotic Prescribing for Acute Sinusitis in Primary Care: A Cross-sectional Study. Clinical Infectious Diseases. doi:10.1093/cid/ciaa736
Vandael, E., Latour, K., Goossens, H., Magerman, K., Drapier, N., Catry, B., . . . the Belgian Point Prevalence Survey Study, G. (2020). Point prevalence survey of antimicrobial use and healthcare-associated infections in Belgian acute care hospitals: results of the Global-PPS and ECDC-PPS 2017. Antimicrobial Resistance & Infection Control, 9(1), 13. doi:10.1186/s13756-019-0663-7
Zarb, P., & Goossens, H. (2011). European Surveillance of Antimicrobial Consumption (ESAC): value of a point-prevalence survey of antimicrobial use across Europe. Drugs, 71(6), 745-755. doi:10.2165/11591180-000000000-00000
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Lim, A., Wong, S., Thian, S., Tew, W., Chiew, S., Lee, X., & Hor, Y. (2021). Antibiotic Prescribing Pattern in Primary Care Practice in Federal Territory Kuala Lumpur and Putrajaya, Malaysia. International Journal of Advancement in Life Sciences Research, 4(4), 15-24. https://doi.org/https://doi.org/10.31632/ijalsr.2021.v04i04.003