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n Health SA Gesondheid - Antimicrobial prescribing patterns in a group of private primary health care clinics in South Africa : research article

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Abstract

Die doel met hierdie studie was om die voorskryfpatrone van antimikrobiese middels in private primêre gesondheidsorginrigtings in Suid-Afrika te ondersoek. 'n Retrospektiewe medisyneverbruikstudie is uitgevoer op data wat verkry is vanaf die databasis van nege private primêre gesondheidsorgklinieke vir die jaar 2001. Antimikrobiese middels is farmakologies geklassifiseer en 'n analise van die verbruik is volgens die aantal pasiënte en konsultasies, die ouderdomsgroep, geslag, diagnose en koste gedoen. Van die 83 655 pasiënte was 49 772 (59.50%) vroulik en 33 650 (40.22%) manlik. In 233 (0.28%) van die gevalle is geen geslag aangedui nie. Die koste van voorgeskrewe mediese items ( = 96 421) het R1 716 319 (60.89%) beloop. Antimikrobiese voorskrifte het 18.69% ( = 96 416) van die total aantal voorskrifte uitgemaak teen 'n koste van R1 045 108 (60.89%). Antimikrobiese middels is gedurende 72% van die besoeke voorgeskryf. Die antimikrobiese middels wat die meeste voorgeskryf is, was die penisilliene (38.17%), sulfoonamiede (22.49%), tetrasikliene (9.34%) en antiprotosoale middels (9.88%). Die mees algemene diagnoses wat die voorskryf van antimikrobiese middels ingesluit het, was virale influenza, boonste lugweginfeksie, akute brongitis en pelviese inflammatoriese siekte. Die voorskryf van antibiotiese middels vir virale siektetoestande het op onoordeelkundige verbruik gedui omdat hierdie infeksies deur nie-bakteriële agente veroorsaak word en gevolglik selfbeperkend is. Antibiotika het dus geblyk onnodig en ontoepaslik te wees. Verdere navorsing in verband met standaard antimikrobiese behandelingsriglyne in private primêre gesondheidsorginrigtings in Suid-Afrika moet uitgevoer word.

The aim of this study was to investigate the prescribing of antimicrobials in private primary health care in South Africa. A retrospective drug utilisation study was conducted on data obtained from the database of nine private primary health care clinics for the year 2001. Antimicrobials were classified pharmacologically and their usage analysed according to number of patients and consultations, age groups, gender, diagnoses and cost. Of the 83 655 patients, 49 772 (59.50%) were female and 33 650 (40.22%) males. No gender was indicated in 233 (0.28%) of the cases. Medicine items ( = 515 976) were prescribed costing R1 716 319. Of these, 18.69% ( = 96 421) were antimicrobials costing R1 045 108 (60.89%). Antimicrobials were prescribed in 72% of the consultations. The antimicrobials that were the most often prescribed were penicillins (38.17%), sulphonamides (22.49%), antiprotozoals (9.88%) and tetracyclines (9.34%) for diagnoses such as viral-influenza, upper-respiratory infections, acute-bronchitis and acute-sinusitis. Antibiotics prescribed for viral diseases indicated inappropriate use because these infections are caused by non-bacterial agents, and thus are self-limiting. Therefore antibiotics were neither necessary nor appropriate. Further investigations should be done on standard antimicrobial treatment-guidelines in private primary health care settings in South Africa.

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/content/health/12/1/EJC35012
2007-03-01
2016-12-06
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