Affiliations 

  • 1 Infectious Disease Unit, Medical Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Selangor, Malaysia
  • 2 Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
  • 3 Paediatrics Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Selangor, Malaysia
  • 4 Emergency Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Selangor, Malaysia
Malays J Med Sci, 2019 Jul;26(4):101-109.
PMID: 31496899 MyJurnal DOI: 10.21315/mjms2019.26.4.12

Abstract

Background: Antimicrobial resistance is a global problem that is perpetuated by the inappropriate use of antibiotics among doctors. This study aims to assess the antibiotic prescription rate for patients with acute upper respiratory infection (URI) and acute diarrhoea.

Methods: A completed clinical audit cycle was conducted in 2018 in the busy emergency department of a public hospital in Malaysia. Pre- and post-intervention antibiotic prescription data were collected, and changes were implemented through a multifaceted intervention similar to Thailand's Antibiotics Smart Use programme.

Results: Data from a total of 1,334 pre-intervention and 1,196 post-intervention patients were collected from the hospital's electronic medical records. The mean (SD) age of participants was 19.88 (17.994) years. The pre-intervention antibiotic prescription rate was 11.2% for acute diarrhoea and 29.1% for acute URI, both of which are above the average national rates. These antibiotic prescription rates significantly reduced post-intervention to 6.2% and 13.7%, respectively, falling below national averages. Antibiotic prescription rate was highest for young children. There were no significant changes in rates of re-attendance or hospital admission following the intervention.

Conclusion: The multifaceted intervention, which included continuing medical education, physician reminders and patient awareness, was effective in improving the antibiotic prescription rates for these two conditions.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.