Pattern of upper respiratory tract infections and physicians' antibiotic prescribing practices in Bahrain.
OBJECTIVE
To evaluate the pattern of antibiotic prescriptions for paediatric upper respiratory tract infections (URTI) and determine the associated predictors for such antibiotic use in the Kingdom of Bahrain.


METHODS
From March 2005 to March 2006, demographic data, clinical presentation, investigations and antibiotic prescription for children with URTI (n = 184) at the Bahrain Defence Force Hospital was recorded. To assess the factors which influence physician antibiotic prescription for URTI, a cross-sectional survey of doctors was carried out using a pre-tested questionnaire which was administered to paediatricians, general practitioners and emergency room physicians.


RESULTS
Antibiotics were given to 95 of the 184 (51.6%) patients, mainly children <3 years (40/95). Significant association was demonstrated for antibiotic prescription, age and diagnosis of tonsillitis or acute otitis media (p < 0.05). Amoxicillin (37/95) was the most frequently prescribed antibiotic, followed by beta-lactam/beta-lactamase combination and second-generation cephalosporins. Fever, younger age, sore throat and presence of earache increased the likelihood of antibiotic prescription. Data from the cross-sectional survey of doctors revealed that lack of national guidelines, parental pressure and diagnostic uncertainty contributed to antibiotic overuse.


CONCLUSIONS
Antibiotic overuse for the treatment of paediatric URTI remains a problem in our setting. We suggest the development of national guidelines which are integrated with structured continuing medical education courses, public awareness campaigns and the introduction of rapid streptococcal antigen tests in the outpatient clinic.
Senok
Abiola C
AC
Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. asenok@sharjah.ac.ae
Ismaeel
Abdulrahman Y
AY
Al-Qashar
Fahad A
FA
Agab
Wahid A
WA
D000293:Adolescent; D017677:Age Distribution; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000145:classification / Q000627:therapeutic use*; D001445:Bahrain; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000188:drug therapy; D010290:Parents / Q000523:psychology; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000145:classification / Q000188:drug therapy*; D014069:Tonsillitis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000658:Amoxicillin