Prescribing antibiotics in government health facilities in the Philippines within the context of the WHO-CARI programme.
ARI deaths at 10.23/1000 infants in the Philippines remain disturbingly 12 and 50 times higher than corresponding rates from the United States and Canada. A cross-sectional study of all government health facilities in two pre-selected areas where the WHO-CARI Program has been implemented was conducted to determine the pattern of prescribing antibiotics for ARI. The therapeutic and diagnostic guideline recommended by the WHO Program was used as a benchmark to identify irrational prescribing. Only 297 encounters out of 885 evaluable cases (35%) had their respiratory rates counted by the prescribers. There was a high proportion of undiagnosed cases at 25% and low agreement between diagnoses of prescribers and those based on the CARI guideline. Moreover, there was failure to treat cases perceived as pneumonia with antibiotics while cases perceived as simple acute respiratory infection were over-treated with the same. However, inter-observer reliability of counting respiratory rates between the research team and caregivers was fair at 0.71.
Vergeire-Dalmacion
G
G
Clinical Epidemiology Unit, Philippines General Hospital, College of Medicine, University of Philippines, Manila.
Delino
R A
RA