A comparison of adherence to national antibiotic guidelines by primary care physicians in Islamabad (Pakistan) and Saint Helen's (England) for common infections

Abstract

Obiective: This study evaluated whether General practitioners (GP) follow national guidelines, while presctibing antibiotics. The study contained data from Islamabad (Pakistan) and Sa int Helen's (England) and also observed which antibiotics were mostly presctibed for common infections, like, gastro-intestinal tract infections (GITs), respiratory tract infections (RTIs) and chest infections. Method: This was a 6-month cross sectional comparison study. Patients visiting the community pharmacies were interviewed and their prescriptions were compared with the recommended guidelines. Data analysis: Data was analyzed and evaluated using SPSS (version 21), descriptive statistics and MS excel 201 6. Results: 379 presctiptions from both the cities, I.e., 181 from Islamabad and 198 from Saint Helen's were enrolled for the study. The results showed that 39.02% amoxicillin was used in Islamabad while 71.9% was used in Saint Helen 's for the treatment of LIpper RTf. Similarly, for acute chest infections (ACI) 47.29% amoxicillin in Islamabad and 62.5% doxycycline in Saint Helen's was prescribed to patients. For dental abscess and H. pylori, amoxicillin was the main drug to be prescribed in both cities. In Islamabad azithromycin and in Saint Helen's erythromyc in, clarithromycin and flucloxacillin were the most common antibiotics to be prescribed for empirical therapy of Eczema. However, evaluation results proved that out of the mentioned percentages for vatious prescribed drugs, some of the prescriptions were completely in accordance with the recommended guidelines while others were following guidelines in a partial marmer. The latter case was commonly observed in Islamabad. Conclusion: In high risk patients of both cities, non-adherence by GPs to the recommended doses and duration of prescribed antibiotics was observed. According to the gathered data, 43% national guidelines were followed in Islamabad while 57% were not followed. On the II/ other hand, scenario is completely different in Saint Helen's where 86 .9 % guidelines were followed and only 13.1 % were left as unfollowed. In short, this study concludes that more adherence to reconm1ended guidelines was shown by Saint Helen 's GPs as compared to that of Islamabad.