May 2011


Antibiotics for URTI and UTI

Prescribing in Malaysian primary care settings

Volume 40, No.5, May 2011 Pages 325-329

Cheong Lieng Teng

Seng Fah Tong

Ee Ming Khoo

Verna Lee

Abu Hassan Zailinawati

Omar Mimi

Wei Seng Chen

Salleh Nordin


Overprescription of antibiotics is a continuing problem in primary care. This study aims to assess the antibiotic prescribing rates and antibiotic choices for upper respiratory tract infections (URTI) and urinary tract infections (UTI) in Malaysian primary care.


Antibiotic prescribing data for URTI and UTI was extracted from a morbidity survey of randomly selected primary care clinics in Malaysia.


Analysis was performed of 1163 URTI and 105 UTI encounters. Antibiotic prescribing rates for URTI and UTI were 33.8% and 57.1% respectively. Antibiotic prescribing rates were higher in private clinics compared to public clinics for URTI, but not for UTI. In URTI encounters, the majority of antibiotics prescribed were penicillins and macrolides, but penicillin V was notably underused. In UTI encounters, the antibiotics prescribed were predominantly penicillins or cotrimoxazole.


Greater effort is needed to bring about evidence based antibiotic prescribing in Malaysian primary care, especially for URTIs in private clinics.

Antibiotic resistance is an emerging global health threat and is likely to have major economic impact.1 The emergence of antibiotic resistance in bacteria is directly linked to selective pressure exerted by the overuse of antibiotics in healthcare settings.2 Indiscriminate antibiotic prescribing is defined both by excessive prescribing and by prescribing an inappropriate antibiotic. In Malaysia, antibiotic prescribing for upper respiratory tract infections (URTI) in public and private primary care settings was reported several years ago.3,4 The present study re-examines the antibiotic prescribing rates for URTI in primary care since the release of sore throat guidelines in 2003.5 Furthermore, it extends to measuring prescribing rates for urinary tract infections (UTI) and aims to determine if the antibiotics chosen for these conditions are consistent with 2008 national antibiotic guidelines.6

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