Open AccessAntibiotic Prescribing for Patients with Upper Respiratory Tract Infections by Emergency Physicians in a Singapore Tertiary Hospital
Author(s) -
Lee WY
Publication year - 2005
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490790501200207
Subject(s) - medicine , antibiotics , respiratory tract infections , medical record , emergency department , emergency medicine , psychological intervention , upper respiratory tract infection , medical prescription , pediatrics , intensive care medicine , respiratory system , psychiatry , microbiology and biotechnology , pharmacology , biology
Objective Despite the paucity of supporting evidence, the use of antibiotics in the management of upper respiratory tract infections (URTI) remains a persistent and worrying trend worldwide. This survey study set out to examine the antibiotic prescribing profile of emergency physicians for patients diagnosed with URTI at a local tertiary hospital. Methods Patients seeking treatment for URTI at the emergency department in the year 2001 were identified by their ICD‐9 code. The electronic medical records of a random sample of these patients were reviewed. Patients with the following documented findings were excluded: (a) a duration of more than 7 days between disease onset and date of consultation, (b) prior antibiotic usage or medical consultation, (c) presentation of purulent sputum and/or purulent nasal discharge, and (d) existing medical conditions requiring antibiotic treatment/prophylaxis. Chi‐square and multivariate analyses were performed to assess the association of patient‐related factors with antibiotic prescribing. Results Of a random sample of 488 cases of URTI, inappropriate antibiotic prescribing was observed in 24% of cases (95% CI 20%, 28%). Significant associations were observed between antibiotic prescribing and month of consultation, patients' temperature and symptom of rhinorrhoea. Conclusion A substantial proportion of emergency department patients with URTI received antibiotics despite the lack of evidence supporting the drugs' effectiveness. Appropriate interventions to promote evidence‐based prescribing amongst emergency physicians are required to reduce the extent of inappropriate antibiotic prescribing as well as to ensure the longevity of antibiotic effectiveness.