title: Drug prescribing practices of general practitioners and paediatricians for childhood diarrhoea in Karachi, Pakistan.
abstract: Observations were made of 996 encounters between children with diarrhoea and practitioners (28 paediatricians, 62 general practitioners) in Karachi, Pakistan. Oral rehydration salt (ORS) was prescribed in more than 50% of encounters by 53% of general practitioners (GPs) and 61% of paediatricians. Sixty-six percent of GPs and 50% of paediatricians prescribed antibacterials, 60% of GPs and 28% of paediatricians prescribed antidiarrhoeals and 39% of GPs and 32% of paediatricians prescribed antiamoebics in more than 30% of their encounters. Looking at all the encounters, we observed that ORS was prescribed in 52 and 51%, antibacterials in 41 and 36%, antidiarrhoeals in 48 and 29%, and antiamoebics in 26 and 22% of encounters by GPs and paediatricians, respectively, Cotrimoxazole was the most frequently prescribed antibacterial by both types of practitioners. Antidiarrhoeals were prescribed more often by GPs than by paediatricians. In 77% of their encounters, GPs dispensed drug formulations known as "mixtures' made in their own dispensing corners. The mean duration of encounters between patients and GPs was 3 +/- 2 minutes and between patients and paediatricians was 9 +/- 4 minutes. These results indicate inadequate prescription of ORS and excessive prescription of antibacterials, antidiarrhoeals and antiamoebics. Intervention strategies need to be planned to improve the prescribing practices of both groups.
authors: Department of Paediatrics, Aga Khan University, Karachi, Pakistan.
authors: S Q
authors: SQ
authors: Nizami
authors: I A
authors: IA
authors: Khan
authors: Z A
authors: ZA
authors: Bhutta
mesh_terms: D000563:Amebicides / Q000600:supply & distribution* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000600:supply & distribution* / Q000627:therapeutic use; D000930:Antidiarrheals / Q000600:supply & distribution* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D003967:Diarrhea / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010348:Patient Care Team / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data
chemical_list: D000563:Amebicides; D000900:Anti-Bacterial Agents; D000930:Antidiarrheals