Irrational antibiotic prescribing: a local issue or global concern?

Area of Science:

• Pharmacology
• Public Health
• Infectious Diseases

Background:

• Antibiotic resistance is a significant global health threat, driven by antibiotic use.
• Understanding outpatient antibiotic prescribing patterns is crucial for antimicrobial stewardship.

Purpose of the Study:

• To evaluate outpatient antibiotic usage in Tehran teaching hospitals.
• To assess the association between prescribing patterns and antibiotic resistance.
• To compare Iranian prescribing habits with international guidelines.

Main Methods:

• Review of 600 outpatient antibiotic prescriptions from December 2011 to May 2012.
• Analysis of antibiotic classes, diagnoses, administration routes, and justification based on Cochrane reviews.
• Comparison with international antibiotic guidelines and studies.

Main Results:

• Penicillins (40%), Cephalosporins (24.5%), and Macrolides (15.3%) were most common. Combinational therapy was used in 18.2%.
• Upper respiratory tract infections (common cold, sore throat) were the most frequent diagnoses (41%).
• 42.7% of antibiotic prescriptions were deemed unjustified, and 22% involved parenteral administration.

Conclusions:

• Significant antibiotic overuse was observed in Tehran teaching hospitals, particularly for upper respiratory tract infections.
• Prescribing habits, accurate diagnosis, and antibiotic administration require immediate attention.
• Findings can inform public health policies to reduce antibiotic consumption and resistance.