title: Antibiotic prescribing practice for acute, uncomplicated respiratory tract infections in primary care settings in New Delhi, India.
abstract: OBJECTIVE
  To obtain information on prescribing rates and choice of antibiotics for acute, uncomplicated respiratory tract infections (RTIs) in the community.
  
  
  METHODS
  Antibiotic use in acute, uncomplicated RTIs consisting of common cold/sore throat/cough for not more than five days was surveyed in the community (December 2007-November 2008) using patient exit interviews at public and private facilities from four localities in New Delhi. Data were collected from 10 public sector facilities and 20 private clinics over one year. The percentage of acute, uncomplicated RTIs patients receiving antibiotics in general and using the Anatomical Therapeutic Chemical classification and the Defined Daily Dose (ATS/DDD) were analysed.
  
  
  RESULTS
  At public and private facilities, 45% (746/1646) and 57% (259/457) of acute, uncomplicated RTI patients were prescribed at least one antibiotic, respectively. The main antibiotic class calculated as percentage of total antibiotics DDDs/1000 prescribed to acute, uncomplicated RTI patients at private clinics was cephalosporins, J01DA (39%), followed by fluoroquinolones, J01MA (24%), penicillins, J01C (19%) and macrolides, J01FA (15%). Newer members from each class were prescribed; older antibiotics such as co-trimoxazole or tetracyclines were rarely prescribed. At public facilities, the main class of antibiotic prescribed was penicillins (31%), followed by macrolides (25%), fluoroquinolones (20%) and cephalosporins (10%).
  
  
  CONCLUSIONS
  Study clearly shows overuse and inappropriate choice of antibiotics for the treatment of acute, uncomplicated RTIs which are mainly due to virus and do not require antibiotic treatment. Results of the study warrant interventional strategies to promote rational use of antibiotics to decrease the overgrowing threat of antibiotic resistance.
authors.affiliation: Department of Pharmacology, V. P. Chest Institute, University of Delhi, Delhi, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Kotwani
authors.forename: Kathleen
authors.initials: K
authors.lastname: Holloway
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000145:classification / Q000627:therapeutic use*; D002648:Child; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D019538:Health Care Surveys; D006801:Humans; D007194:India; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cuidados primarios; Infecciones del tracto respiratorio superior; Prescripción de antibióticos; Resistencia a antibióticos; Uso racional de antibióticos; antibiotic resistance; antibiotics prescribing; community pharmacists; farmacias comunitarias; infections des voies respiratoires supérieures; pharmaciens d'officine; prescription des antibiotiques; primary care; rational use of antibiotics; résistance aux antibiotiques; soins primaires; upper respiratory tract infections; utilisation rationnelle des antibiotiques