Antimicrobial prescribing pattern in primary care: a comparison between general practitioners and family physicians in Bahrain

Abstract number: 1134_01_111

Al Khaja K.A., Sequeira R., Damanhori A., Ismaeel A.

Objectives:  

The aim of this study was to determine antimicrobial prescribing pattern in primary care and to find out whether prescribing pattern is influenced by physicians’ training background.

Methods:  

A retrospective prescription-based study was carried out in 17 out of 20 primary health care centres in Bahrain. Prescriptions (n = 4367) were collected randomly during a weekday in July 2003.

Results:  

Systemic antimicrobials ranked the fourth most commonly prescribed therapeutic classes of drugs. The top-ten most commonly prescribed antimicrobials, in descending order, were amoxycillin (14.3%), cephalexin (5.3%), erythromycin (1.1%), cloxacillin (0.8%), metronidazole (0.8%), ciprofloxacin (0.5%), cefadroxil (0.4%) cotrimoxazole (0.3%), tetracyclines (0.3%), norfloxacin (0.1%) and procaine penicillin (0.02%). Amoxycillin, cephalexin, erythromycin and cotrimoxazole were prescribed by general practitioners (GPs) more often than by family physicians (FPs) (p < 0.05). With respect to prescribing of other antimicrobials and anthelmintic mebendazole the differences between GPs and FPs were nonsignificant. Topical antimicrobial preparations for ear and nose infections were prescribed by GPs in a rate significantly higher than by FPs (p < 0.05); of these topical antimicrobials, chloramphenicol and locacorten vioform (flumethasone + clioquinol) ear drops and sulphacetamide eye drops were more often prescribed by GPs (p < 0.05). There were no significant differences in prescribing patterns between GPs and FPs as regards various topical antimicrobials used for oropharyngeal, skin, and vulvo-vaginal infections.

Conclusion:  

Antimicrobial prescribing differences in primary care were observed between GPs and FPs. The generalizability of these findings is uncertain. Judicious use of antimicrobials should be encouraged to reduce the dramatic increase in the prevalence of resistant microorganisms worldwide.