Antibiotic-Prescribing Practices of Primary Care Prescribers for Acute Diarrhea in New Delhi, India

• Published in: Value in health Vol. 15; no. 1; pp. S116 - S119
• Main Authors: Kotwani, Anita, PhD, Chaudhury, Ranjit Roy, MBBS, DPhil, FRCP, Holloway, Kathleen, MRCP, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2012
• Subjects: acute diarrhea; Acute Disease; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antibiotics; Children; Clinics; community; Diarrhea - drug therapy; Diarrhoea; Drug Utilization; Humans; India; Internal Medicine; Physicians, Primary Care - statistics & numerical data; Practice Patterns, Physicians' - statistics & numerical data; Prescribed; Prescribing; primary care; Private Sector - statistics & numerical data; Public Sector - statistics & numerical data; Seasons; treatment guidelines; India; primary care; treatment guidelines; community; antibiotics; acute diarrhea
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2011.11.008

Abstract Objective To obtain information on the current prescribing rates of antibiotics in acute diarrhea in the community. Methods Antibiotic use in acute diarrhea in the community (December 2007–November 2008) was surveyed by using patients' exit interviews at public and private facilities from four residential localities. Data were collected from 10 public sector facilities and 20 private clinics over 1 year. The percentage of patients receiving antibiotics and the prescribing pattern of antibiotics were analyzed by using the anatomical therapeutic chemical classification and the defined daily dose. Results At public facilities 43% (171 of 398) and at private facilities 69% (76 of 110) of the patients with acute diarrhea were prescribed at least one antibiotic. Diarrhea increased during peak humid summer months, but doctors were fairly consistent in their antibiotic prescribing throughout the year. The main antibiotic class that was prescribed in both public and private sector facilities was fluoroquinolones, J01MA (91.5% and 96%, respectively). Pediatricians working in the private sector prescribed antibiotics to 51.5% (17 of 33) of children with diarrhea, whereas pediatricians working in the public sector prescribed antibiotics to 23% of children with acute diarrhea. At public facilities, the most commonly prescribed fluoroquinolone was norfloxacin, followed by ofloxacin and ciprofloxacin. At private clinics, it was ofloxacin followed by ciprofloxacin. Conclusions This study clearly showed the irrational use of antibiotics for the treatment of acute diarrhea in children and adults that warrants interventional strategies.