Antibiotherapy management in respiratory infections in ambulatory in Tunisia

Ear, Nose & Throat (ENT) and acute respiratory tract (ART) infections are the main causes of inappropriate antibiotic prescribing. To evaluate the antibiotics prescribing practices for these infections, we conduct an observational study with 23 general practionners (GPs) working in private offices of the East Central Region of Tunisia. Among the 374 patients presenting ENT or ART infections, 193 were men (51.6%). The mean age was 45.6 ± 16.7 years. Comorbidities were present in 174 patients (51.9%). The first visit was made 3.7 ± 6 days after the beginning of the symptoms. The main diagnoses are acute bronchitis (37.4%), tonsillitis (33.4%) and acute maxillary sinusitis (20.9%). Additional tests (chest-X-ray and Lab-test) were prescribed for only 75 patients (20%). An antibiotic was prescribed for 360 patients (96.2%), for an average of 9.1 ± 2.3 days. The main prescribed antibiotics are β-lactams (58.3%), fluoroquinolones (23.5%) and macrolides (15.6%). Overall, the rate of inappropriate antibiotic prescription was 34.1%, the highest rates was noted in Exacerbation of the COPD (73.2%) and pneumonia (42.1%). Antipyretics and corticosteroids were prescribed in 71.4% and 44.7% respectively. The clinical success rate was noted in 375 cases (89%). The average cost of an infectious episode amounts to about $ 45 ± 20. This study underlines over-prescribing of antibiotics with unnecessary additional costs which may be related to the non-use of diagnostic tools. National guidelines should be developed in order to reduce unnecessary antibiotic prescription and emerging of bacterial resistance. Antibiotherapy management of respiratory infections in ambulatory in Tunisia M. Chakroun1, A. Chakroun1, M. Hsaïri2, Working group3 1 Department of Infectious Diseases. Fattouma Bourguiba Teaching Hospital. Monastir. 2 Department of epidemiology and medicine preventive. Faculty of Medicine. Tunis. 3 List of participating authors on page 7. Contact information: