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Antibiotic prescribing amongst South African general practitioners in private practice: an analysis of a health insurance database. | LitMetric

Antibiotic prescribing amongst South African general practitioners in private practice: an analysis of a health insurance database.

JAC Antimicrob Resist

Antimicrobial Research Unit, College of Health Sciences, University of Kwa-Zulu, Natal, Durban, South Africa.

Published: October 2022

AI Article Synopsis

Article Abstract

Objectives: To investigate the appropriateness of antibiotic prescribing among GPs in the private primary healthcare sector in South Africa.

Methods: An anonymized national database of claims for antibiotic prescriptions was obtained from a large medical insurer. Antibiotic prescriptions were categorized based on International Classification of Diseases (ICD-10) codes as 'appropriate', 'potentially appropriate' and 'inappropriate' using a classification scheme developed by Chua ( 2019; 364: k5092). Further assessments of antibiotic choice, dosage and duration of treatment were carried out to determine the appropriateness of 'appropriate' and 'potentially appropriate' prescriptions in comparison with treatment guidelines.

Results: In February 2018, 188 141 antibiotics were prescribed for 174 889 patients who consulted GPs in the private sector. Penicillins were the most frequently prescribed antibiotic class, making up 40.7% of all antibiotics prescribed. Amoxicillin/clavulanic acid was the most frequently prescribed antibiotic, making up 28.6% of all antibiotics prescribed. Diseases of the respiratory system generated the highest number of prescriptions, making up 46.1% of all diagnoses. Of all prescriptions, 8.8% were appropriate, 32.0% were potentially appropriate, 45.4% were inappropriate and 13.8% could not be assessed. Of the appropriately and potentially appropriately prescribed antibiotics, 30.8% were correct antibiotic selections. Of the correctly selected antibiotics for adults, 57.7% had correct doses. Of the antibiotics prescribed with correct doses for adults, 76.7% had correct dosage frequencies and durations of treatment.

Conclusions: The study revealed that antibiotics were frequently prescribed inappropriately by GPs in the private primary healthcare sector. There is thus a need to develop stewardship interventions in the sector.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524566PMC
http://dx.doi.org/10.1093/jacamr/dlac101DOI Listing

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