Please use this identifier to cite or link to this item: http://hdl.handle.net/10311/2252
Title: Assessment of prescribing practices at the primary healthcare facilities in Botswana with an emphasis on antibiotics: findings and implications
Authors: Mashalla, Yohana
Setlhare, Vincent
Sepako, Enoch
Tiroyakgosi, Celda
Kgatlwane, Joyce
Chuma, Mpo
Godman, Brian
Massele, Amos
Keywords: Primary health care
urban primary health facilities
developing countries
antibiotics
antimicrobial resistance
drugs indicators
Botswana
Issue Date: 1-Dec-2017
Publisher: Wiley,https://www.wiley.com/en-us
Citation: Masalla, Y. et al (2017) Assessment of prescribing practices at the primary healthcare facilities in Botswana with an emphasis on antibiotics: findings and implications. The International Journal of Clinical Practice, Vol. 71, No. 12, pp. 1-10
Abstract: Background and Aims: Inappropriate drug prescribing has increased especially in developing countries where systems for monitoring medicine use are not well developed. This increases the rate of antimicrobial resistance. The study aim was to assess the prescribing patterns among urban primary health facilities in Botswana to provide future guidance including developing future quality indicators. Methods: Retrospective data from patients’ records between January and December 2013 in 19 clinics were collected in a cross-sectional study. The WHO/International Network for Rational Use of Drugs indicators were used to assess prescribing patterns in the study clinics. Results: Average number of drugs per prescription was 2.8; 78.6% of the prescribed antibiotics were by International Non-proprietary Name and 96.1% complied with the Botswana Essential Drugs List. Overall rate of antibiotic prescribing was high (42.7%) with 14.7%, 5.9% and 1.3% of prescriptions having two, three and four antibiotics, respectively. Systemic antibiotics (JO1C) accounted for 45.4% of prescribed antibiotics of which amoxicillin accounted for 28.4% and metronidazole 14.4% of all antibiotic prescriptions. There was low use of co-amoxiclav (0.3% of all antibiotic prescriptions). Third generation cephalosporins and macrolides accounted for 9.8% and 6.2% of antibiotic prescriptions respectively, with no prescribing of fluoroquinolones. The majority of indications (87%) for antibiotic prescriptions were according to ICD classification. Conclusions: While most indications for antibiotic prescriptions were based on signs and symptoms according to ICD, antibiotic prescribing rates were high with some conditions not requiring antibiotics because they are viral infections. There is a need to further improve prescribing practices through induction and training of in-service prescribers. An effective management tool for monitoring antibiotic prescribing practices at Primary Health Care facilities should be designed and implemented, including developing robust quality indicators.
URI: http://hdl.handle.net/10311/2252
ISSN: 1368-5031 (print), 1742-1241 (electronic)
Appears in Collections:Research articles (Dept of Biomedical Sciences)

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