title: Antibiotic prescribing practice in management of cough and/or diarrhoea in Moshi Municipality, Northern Tanzania: cross-sectional descriptive study.
abstract: BACKGROUND
  The increase in resistance of many pathogens to currently available antibiotics has been recognized as life-threatening problem. The development of drug resistance is promoted by irrational prescribing behavior. Inappropriate use of antibiotics is attributed by over-prescription, inadequate dosage and use for non-bacterial infections. The purpose of this study was to assess antibiotic prescribing practices in the management of diarrhoea and cough among children attending hospitals in Moshi municipal, Tanzania.
  
  
  METHODS
  We conducted a cross-sectional descriptive hospital based study, from September 2010 to March 2011. All children presenting with diarrhoea and cough, aged between one month and 5 years attended at the two hospitals were enrolled. Data were collected by a standard questionnaire. Information on the prescribed drugs was obtained from patient files.
  
  
  RESULTS
  A total of 384 children were enrolled. Of these, 326 (84.9%) received antibiotics; common prescribed antibiotics were penicillins, sulphonamides, aminoglycosides and macrolides. Eighty percent of children with acute watery diarrhoea and 68.9% with common cold were given antibiotics inappropriately. Inappropriate antibiotic prescription was significantly associated with prescriber being a clinical officer and assistant medical officer, and child having diarrhoea. Inappropriate antibiotic dosage was significantly occurred when prescriber was clinical officer with reference to medical officer.
  
  
  CONCLUSIONS
  This study observed a high antibiotic prescription rate by clinicians and treatment guidelines for management of patients who presented with cough and/or diarrhoea are followed. Continuing professional development programmes for clinicians on prescription would help in reducing irrational prescribing practices.
authors.affiliation: Department of Paediatric and Child Health, Kilimanjaro Christian Medical University College, P O Box 2240, Moshi, Tanzania.
authors.forename: Judith John
authors.initials: JJ
authors.lastname: Gwimile
authors.forename: Seif Abdallah
authors.initials: SA
authors.lastname: Shekalaghe
authors.forename: Gibson Nsokolo
authors.initials: GN
authors.lastname: Kapanda
authors.forename: Elton Richard
authors.initials: ER
authors.lastname: Kisanga
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003371:Cough / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000188:drug therapy*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013636:Tanzania
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics use; antibiotic prescribing; cough; diarrhea; irrational prescribing; pneumonia; under-five