title: Prescribing patterns for upper respiratory tract infections: a prescription-review of primary care practice in Kedah, Malaysia, and the implications.
abstract: OBJECTIVE
  It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among 10 public primary healthcare centers in Kedah, Malaysia, from 1 January to 31 March 2014.
  
  
  RESULTS
  A total of 123,524 prescriptions were screened and analyzed. Of these, 7129 prescriptions were for URTI, with 31.8% (n = 2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic, constituting 61% (n = 1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p = 0.001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ = 0.122).
  
  
  CONCLUSIONS
  Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programs and further educational initiatives are ongoing in Malaysia to improve antibiotic use.
authors.affiliation: a 1 Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
authors.forename: Rabiatul Salmi
authors.initials: RS
authors.lastname: Rezal
authors.affiliation: a 1 Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
authors.forename: Mohamed Azmi
authors.initials: MA
authors.lastname: Hassali
authors.affiliation: b 2 Pharmacy Practice Department, College of Pharmacy, Qassim University, Buraydah 52571, Saudi Arabia.
authors.forename: Alian A
authors.initials: AA
authors.lastname: Alrasheedy
authors.affiliation: a 1 Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
authors.forename: Fahad
authors.initials: F
authors.lastname: Saleem
authors.affiliation: c 3 Pharmaceutical Services Division, Ministry of Health, Kuala Lumpur, Malaysia.
authors.forename: Faridah Aryani Md
authors.initials: FA
authors.lastname: Yusof
authors.affiliation: c 3 Pharmaceutical Services Division, Ministry of Health, Kuala Lumpur, Malaysia.
authors.forename: Mardhiyah
authors.initials: M
authors.lastname: Kamal
authors.affiliation: c 3 Pharmaceutical Services Division, Ministry of Health, Kuala Lumpur, Malaysia.
authors.forename: Rosminah
authors.initials: R
authors.lastname: Mohd Din
authors.affiliation: d 4 Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden.|e 5 Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Godman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Malaysia; antibiotics stewardship programs; guidelines; inappropriate use of antibiotics; primary healthcare centres; upper respiratory tract infections