Patterns of antibiotic prescribing and appropriateness for respiratory tract infections in a teaching hospital in Jordan

Background Inappropriate use of antibiotics is a public health concern that promotes antibiotic resistance globally. This study aimed to investigate the patterns of antibiotic prescribing for respiratory tract infections (RTIs) in Jordan to encourage judicious antibiotic prescribing. Methods The researchers conducted a retrospective secondary analysis of oral antibiotics prescribed in the family medicine clinics in a teaching university hospital in Jordan in 2017. Antibiotic prescribing rates and the types of antibiotics prescribed were analysed. Patients' age, gender, type of insurance, and the RTIs diagnosis were investigated as possible factors that could be associated with inappropriate antibiotic prescribing for RTIs. Results Our findings revealed that 20 133 prescriptions, (27.3%) of all the prescriptions issued in the family medicine clinics included an antibiotic. Penicillins accounted for 52.7% of all the antibiotics prescribed, followed by macrolides (21.6%) and cephalosporins (16.4%). The most common indication for prescribing the antibiotics was RTIs (51.1%). The majority of antibiotics prescribed for respiratory diagnosis were for upper RTIs (URTI) (61.5%), followed by otitis media (16.9%) and tonsillitis (15.4%). Only 28.8% of all the antibiotics prescribed were appropriate and indicated. Older patients were significantly more likely to be prescribed an antibiotic compared to the younger (P < .001). Also, hospital employees and university employees were significantly more likely to be prescribed an antibiotic compared to the Ministry of Health employees (P < .001). Conclusions Antibiotics were inappropriately prescribed, and their prescribing rate was high in the outpatient setting in the family medicine clinics studied in Jordan. This calls for policy-level interventions to promote judicious antibiotic prescribing to minimise the avoidable burden of microbial resistance and unnecessary expenditure.

Automated summary

The study found that inappropriate use of antibiotics is a global public health issue and aimed to investigate patterns of antibiotic prescribing for respiratory tract infections in Jordan. Analysis of prescriptions in family medicine clinics revealed that 27.3% of all prescriptions included antibiotics, with penicillins being the most commonly prescribed. However, only 28.8% of all antibiotics prescribed were considered appropriate. Older patients and hospital/university employees were more likely to be prescribed antibiotics compared to younger patients and Ministry of Health employees.