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Abstract

Background: Antibiotic over prescription is a worldwide problem. It represents a major factor
for the development of bacterial resistance and treatment failure. Treating those resistant
bacterial infections requires expensive and limited antibiotics.
Objectives: Measure the extent of antibiotic prescription in hospitals out-patient clinics and
primary health care centers.
Materials and Methods: An observational cross-sectional analytical study was carried out on
688 patients of both genders and different ages according to Dobson's formula, excluded patients
with TB. The study was done in almost all the out-patient clinics in Al-Nasiriya governmental
hospitals including (Al-Hussein Teaching Hospital, Bint Al-Huda Teaching Hospital and AlHabboobi Teaching Hospital) along with fifteen randomly selected primary health care centers
from the 2nd of January, 2017 to the 1st of October, 2017. The prevalence of the problem (46%)
took from the research pilot study. Statistical Package for Social Sciences (SPSS) was used for
analysis, P value less than 0.05 was considered as significant.
Results: The results showed a high prescription rate of antibiotics (61%), cephalexin was the
most frequently prescribed antibiotic (18.9%), while nitrofurantoin, amikacin and doxycycline
were the least prescribed drugs with a prevalence of (0.2%) each.
Conclusion: A high prescription rate was an obvious result in this study. Giving the fact that
cephalexin was the most prescribed antibiotic.

Keywords

Antibiotic over prescription bacterial resistance

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References

  1. Rustam I. AminovFront Microbiol. 2010; 1: 134. Prepublished online 2010 Oct 29.
  2. Published online 2010 Dec 8.
  3. Nordlie AL, Andersen BM. Parents' attitudes to the prescription of antibiotics to children.
  4. Tidsskrift for den Norske Laegeforening. 2004;124(17):2229–2231.
  5. Buñuel Álvarez JC, Fortea Gimeno E, Cortés Marina RB, Vila Pablos C, Blanch Risec F,
  6. Estany Delgado M. Antibiotic use in primary care. Do we know what parents think? Anales de
  7. Pediatria. 2004;61(4):298–304.
  8. Paluck E, Katzenstein D, Frankish CJ, Herbert CP, Milner R, Speert D, Chambers K.
  9. Prescribing practices and attitudes toward giving children antibiotics. Canadian Family
  10. Physician. 2001;47:521–527.
  11. Pechère JC. Patients’ interviews and misuse of antibiotics. Clinical Infectious Diseases.
  12. ;33(3):S170–S173.
  13. Harnden A, Perera R, Brueggemann AB, et al. Respiratory infections for which general
  14. practitioners consider prescribing an antibiotic: a prospective study. Archives of Disease in
  15. Childhood. 2007;92(7):594–597.
  16. Mangione-Smith R, Elliott MN, Stivers T, McDonald L, Heritage J, McGlynn EA.
  17. Racial/ethnic variation in parent expectations for antibiotics: implications for public health
  18. campaigns. Pediatrics. 2004;113(5):e385–e394
  19. overprescription | Definition of overprescription in English by Oxford Dictionaries.
  20. Oxford Dictionaries | English. 2018 [cited 9 April 2018]. Available from:
  21. https://en.oxforddictionaries.com/definition/overprescription
  22. Goossens H, Ferech M, Vander SR, et al. Outpatient antibiotic use in Europe and
  23. association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–587.
  24. Little P, Hobbs FD, Moore M, et al. Clinical score and rapid antigen detection test to
  25. guide antibiotic use for sore throats: randomized controlled trial of PRISM (primary care
  26. streptococcal management) BMJ. 2013;347:f5806.
  27. Bennett P, Brown M, Sharma P. Clinical pharmacology. 10th ed. Oxford: Churchill
  28. Livingstone; 2012.sec.3:175.
  29. History of Antibiotics - The Discovery by Alexander Fleming. Explorable.com. 2017
  30. [cited 2 October 2017]. Available from: https://explorable.com/history-of-antibiotics
  31. Curr Biol. 2009 Jun 9; 19(11): R437–R441. doi: 10.1016/j.cub.2009.04.001
  32. Keyes K, Lee MD, Maurer JJ. 2003. Antibiotics: Mode of Action, Mechanisms of
  33. Resistance and Transfer. Microbial Food Safetry in Animal Agriculture Current Topics. ME
  34. Torrence and RE Isaacson, eds. Iowa State Press, Ames, Iowa, USA.
  35. Srivastava A. antibiotics curse or boon. new delhi times. 2017;:1-2.
  36. Antibiotics-An Investigatory Project. https://ar.scribd.com/doc/230531521/AntibioticsAn-Investigatory-Project. 2017.
  37. WHO Policy Perspectives on Medicines-Promoting Rational Use of Medicines: Core
  38. Components, World Health Organization. September 2002, Geneva.
  39. Overuse. TheFreeDictionary.com. 2017 [cited 9 April 2018]. Available from:
  40. http://www.thefreedictionary.com/overuse
  41. Ramanan Laxminarayan, Ranjit Roy Chaudhury PLoS Med. 2016 Mar; 13(3): e1001974.
  42. Published online 2016 Mar 2.
  43. Gillings M. Research suggests the consequences of overuse of antibiotics is now reaching
  44. the Amazon. Sydney, Macquarie University; 2013. p. 1.
  45. Pending Consequences Overuse of Antibiotics Puts People’s Health at Risk | Health Care
  46. News. Healthcarenews.com. 2017 [cited 9 April 201]8. Available from:
  47. http://healthcarenews.com/pending-consequences-overuse-of-antibiotics-puts-peoples-health-atrisk/
  48. D. Borchert, L. Sheridan, A. Papatsoris, Z. Faruquz, J. M. Barua, I. Junaid, Y. Pati, F.
  49. Chinegwundoh, N. Buchholz. Prevention and treatment of urinary tract infection with probiotics:
  50. Review and research perspective. Indian J Urol. 2008 Apr-Jun; 24(2): 139–144
  51. Antibiotic resistance. http://www.who.int/mediacentre/factsheets/antibioticresistance/en/. 2017.
  52. Myers J. Which countries use the most antibiotics. World Economic Forum. 2015;:1.
  53. Habibzadeh F. The Lancet Middle East Edition, NIOC Medical Education and Research
  54. Center, Shiraz, Iran. Farrokh Habibzadeh 2010.
  55. [cited 9 April 2018]. Available from:
  56. https://academic.oup.com/inthealth/articleabstract/9/2/124/3051858/Antibiotic-prescribing-foracute respiratory?redirectedFrom=fulltext
  57. Hisham Aljadhey, Ghada A. Assiri, Mansour A. Mahmoud, Sinaa Al-Aqeel, Michael
  58. Murray Saudi Med J. 2015; 36(3): 328–334.
  59. Al-Jumaili A, Hussein A, Al-Rekabi M, Raheem S, Ernst E. Antimicrobial utilization in
  60. an Iraqi province: a comprehensive evaluation of antibiotic source and cost. International Journal
  61. of Pharmacy Practice. 2017;25(1):81-88.
  62. Defined Daily Dose (DDD). World Health Organization. 2017 [cited 9 April 2018].
  63. Available from: http://www.who.int/medicines/regulation/medicines-safety/toolkit_ddd/en/
  64. Pechère JC et al. Non-compliance with antibiotic therapy for acute community infections:
  65. a global survey. International Journal of Antimicrobial Agents, 2007, 29:245–253.
  66. Definition of MISUSE. Merriam-webster.com. 2018 [cited 9 April 2018]. Available
  67. from: https://www.merriam-webster.com/dictionary/misuse
  68. Definition of OVERUSE. Merriam-webster.com. 2018 [cited 9 April 2018]. Available
  69. from: https://www.merriam-webster.com/dictionary/overuse
  70. Chetley A, Hardon A, Hodgkin C, Haaland A, Fresle D. How to Improve the Use of
  71. Medicines by Consumers. Geneva: World Health Organization; 2007
  72. Antibiotic Therapy Principles - infectionNet [Internet]. Infectionnet.org. 2017 [cited 2
  73. October 2017]. Available from: http://infectionnet.org/notes/antibiotic-therapy-principles/
  74. British National Formulary (BNF). Sarah Mohamad september2015-march2016
  75. Leekha S, Terrell C, Edson R. General Principles of Antimicrobial Therapy. Mayo Clinic
  76. Proceedings. 2011;86(2):156-167. Available from: http://
  77. www.mayoclinicproceedings.org/article/S0025-6196(11)60140-7/pdf
  78. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of
  79. America/American Thoracic Society consensus guidelines on the management of communityacquired pneumonia in a Kumar A, Ellis P, Arabi Y, Roberts D, Light B, Parrillo JE, et al.
  80. Cooperative Antimicrobial Therapy of Septic Shock Database
  81. Research Group. Initiation of inappropriate antimicrobial therapy results in a fivefold
  82. reduction of survival in human septic shock. Chest. 2009;136:1237–48.
  83. Micek ST, Lloyd AE, Ritchie DJ, Reichley RM, Fraser VJ, Kollef MH. Pseudomonas
  84. aeruginosa bloodstream infection: Importance of appropriate initial antimicrobial treatment.
  85. Antimicrob Agents Chemother. 2005;49:1306–11.
  86. Kollef MH. Inadequate antimicrobial treatment: An important determinant of outcome
  87. for hospitalized patients. Clin Infect Dis. 2000;31:S131–8.
  88. Lautenbach E, Patel JB, Bilker WB, Edelstein PH, Fishman NO. Extended-spectrum
  89. beta-lactamase-producing Escherichia coli and Klebsiellapneumoniae: Risk factors for infection
  90. and impact of resistance on outcomes. Clin Infect Dis. 2001;32:1162–71.
  91. Schwaber MJ, Carmeli Y. Mortality and delay in effective therapy associated with
  92. extended-spectrum beta-lactamase production in Enterobacteriaceae bacteraemia: A systematic
  93. review and meta-analysis. J Antimicrob Chemother. 2007;60:913–20.
  94. Ritter J, Lewis L, Mant T, Ferro A. A textbook of clinical pharmacology and
  95. therapeutics. 5th ed. London: Hodder Arnold; 2008.p324-325.
  96. Levison ME. Pharmacodynamics of antimicrobial drugs. Infect Dis Clin North Am.
  97. ;18(3):451-465, vii.
  98. Pillai SK, Eliopoulos GM, Moellering RC Jr. Section E: anti-infective therapy: principles
  99. of anti-infective therapy. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, douglas, and
  100. Bennett's Principles and Practice of infectious diseases. Vol 1. 7th ed. Philadelphia, PA:
  101. Churchill Livingstone/Elsevier; 2010.
  102. Crider KS, Cleves MA, Reefhuis J, Berry RJ, Hobbs CA, Hu DJ. Antibacterial
  103. medication use during pregnancy and risk of birth defects: National Birth Defects Prevention
  104. Study. Arch Pediatr Adolsc Med. 2009;163(11):978-985
  105. Milo G, Katchman EA, Paul M, Christiaens T, Baerheim A, Leibovici L. Duration of
  106. antibacterial treatment for uncomplicated urinary tract infection in women. Cochrane Database
  107. Sys Rev. 2005;(2):CD004682
  108. Dunbar LM, Wunderink RG, Habib MP, et al. High-dose, short-course levofloxacin for
  109. community-acquired pneumonia: a new treatment paradigm. Clin Infect Dis. 2003;37(6):752-760.
  110. Waldman S, Terzic A. Pharmacology and therapeutics. 5th ed. Philadelphia, Pa.:
  111. Saunders/Elsevier; 2009;a325.
  112. MOH, Thi-Qar Directorate of Health/Section of Health Statistics;2016,118.
  113. Barah F, Gonçalves V. Antibiotic use and knowledge in the community in Kalamoon,
  114. Syrian Arab Republic: a cross-sectional study. East Mediterr Health J. 2010 May;16(5):516-21
  115. Otoom S, Batieha A, Hadidi H, Hasan M, Al-Saudi K. Evaluation of drug use in Jordan
  116. using WHO prescribing indicators. East Mediterr Health J 2002. Jul-Sep;8(4-5):537-543
  117. Assessment of national pharmaceutical sector North Sudan 2007,MOH, DGoP.
  118. Leila Safaeian, Ali-Reza Mahdanian, Mansoor Hashemi-Fesharaki, Soolmaz Salami,
  119. Javad Kebriaee-Zadeh, Gholam-Hossein Sadeghian Oman Med J. 2011 May; 26(3): 205–206.
  120. Katherine E. Fleming-Dutra, MD1; Adam L. Hersh, MD, PhD2; Daniel J. Shapiro3; et al
  121. JAMA. 2016;315(17):1864-1873.
  122. Shallcross L, Beckley N, Rait G, Hayward A, Petersen I. Antibiotic prescribing
  123. frequency amongst patients in primary care: a cohort study using electronic health records.
  124. Journal of Antimicrobial Chemotherapy. 2017;72(6):1818-1824.
  125. Ternhag A, Grünewald M, Nauclér P, Tegmark Wisell K. Antibiotic consumption in
  126. relation to socio-demographic factors, co-morbidity, and accessibility of primary health care.
  127. Scandinavian Journal of Infectious Diseases. 2014;46(12):888-896.
  128. Malo S, José Rabanaque M, Feja C, Jesús Lallana M, Aguilar I, Bjerrum L. High
  129. Antibiotic Consumption: A Characterization of Heavy Users in Spain. Basic & Clinical
  130. Pharmacology & Toxicology. 2014;115(3):231-236.
  131. Schröder W, Sommer H, Gladstone B, Foschi F, Hellman J, Evengard B et al. Gender
  132. differences in antibiotic prescribing in the community: a systematic review and meta-analysis.
  133. Journal of Antimicrobial Chemotherapy. 2016;71(7):1800-1806.
  134. Teng, C., Leong, K., Aljunid, S., & Cheah, M. (2004).
  135. Antibiotic Prescription In Upper Respiratory Tract Infections.
  136. Asia Pacific Family Medicine, 3(1-2), 38-45
  137. Lindbaek M. Prescribing antibiotics to patients with acute cough and otitis media. British
  138. Journal of General Practice.2006;56:164-5
  139. Denes E, Prouzergue J, Ducroix-Roubertou S, Aupetit C, Weinbreck P. Antibiotic
  140. prescription by general practitioners for urinary tract infections in outpatients. European Journal
  141. of Clinical Microbiology & Infectious Diseases. 2012;31(11):3079–3083.
  142. Siddiqi S, Hamid S, Rafique G, Chaudhry S, Ali N, Shahab S et al. Prescription practices
  143. of public and private health care providers in Attock District of Pakistan. The International
  144. Journal of Health Planning and Management. 2002;17(1):23-40.
  145. Glowacki R, Schwartz D, Itokazu G, Wisniewski M, Kieszkowski P, Weinstein R.
  146. Antibiotic Combinations with Redundant Antimicrobial Spectra: Clinical Epidemiology and Pilot
  147. Intervention of Computer‐Assisted Surveillance. Clin Infect Dis. 2003 Jul 1;37(1):59-64. Epub
  148. Jun 23.
  149. Fletcher-Lartey S, Yee M, Gaarslev C, Khan R. Why do general practitioners prescribe
  150. antibiotics for upper respiratory tract infections to meet patient expectations: a mixed methods
  151. study. 2016 Oct 24;6(10):e012244

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