Multi-Faceted Intervention to Improve the Antibiotic Prescriptions among Doctors for Acute URI and Acute Diarrhoea Cases: The Green Zone Antibiotic Project
10.21315/mjms2019.26.4.12
- Author:
Kim Heng Tay
1
;
Farnaza Ariffin
2
;
Benedict Lh Sim
1
;
Sheau Yin Chin
3
;
Ammar Che sobry
4
Author Information
1. Infectious Disease Unit, Medical Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Selangor, Malaysia
2. Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
3. Paediatrics Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Selangor, Malaysia
4. Emergency Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Selangor, Malaysia
- Publication Type:Journal Article
- Keywords:
Keywords;
antibiotics, acute diarrhoea, acute upper respiratory infection, clinical audit, prescription, multifaceted intervention, rational
- From:Malaysian Journal of Medical Sciences
2019;26(4):101-109
- CountryMalaysia
- Language:English
-
Abstract:
Background: Antimicrobial resistance is a global problem that is perpetuated by
the inappropriate use of antibiotics among doctors. This study aims to assess the antibiotic
prescription rate for patients with acute upper respiratory infection (URI) and acute diarrhoea.
Methods: A completed clinical audit cycle was conducted in 2018 in the busy emergency
department of a public hospital in Malaysia. Pre- and post-intervention antibiotic prescription
data were collected, and changes were implemented through a multifaceted intervention similar to
Thailand’s Antibiotics Smart Use programme.
Results: Data from a total of 1,334 pre-intervention and 1,196 post-intervention patients
were collected from the hospital’s electronic medical records. The mean (SD) age of participants
was 19.88 (17.994) years. The pre-intervention antibiotic prescription rate was 11.2% for
acute diarrhoea and 29.1% for acute URI, both of which are above the average national rates.
These antibiotic prescription rates significantly reduced post-intervention to 6.2% and 13.7%,
respectively, falling below national averages. Antibiotic prescription rate was highest for young
children. There were no significant changes in rates of re-attendance or hospital admission
following the intervention.
Conclusion: The multifaceted intervention, which included continuing medical education,
physician reminders and patient awareness, was effective in improving the antibiotic prescription
rates for these two conditions.
- Full text:3.2019my0805.pdf
