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