title: Antibiotic prescription patterns for upper respiratory tract infections in the outpatient Qatari population in the private sector.
abstract: BACKGROUND
  Antibiotics are often inappropriately prescribed for upper respiratory tract infections (URTIs) in developed countries. Data on the proportion of inappropriate prescriptions are lacking from the Middle East and other developing countries.
  
  
  METHODS
  Health insurance claims for all antibiotics prescribed for URTIs in the private sector in the State of Qatar between May 2014 and December 2015 were retrieved. During the study period, health insurance was limited to Qatari nationals. Topical antibiotics were excluded. Data on the prescriber's specialty, as listed with the licensing authority, were also retrieved. Diagnoses were classified as appropriate or inappropriate based on the likelihood of a bacterial etiology that may warrant antibiotic use.
  
  
  RESULTS
  A total of 75 733 claims were made during the study period. Of these, 41 556 (55%) were for an appropriate indication, while 34 177 (45%) were for an inappropriate indication. The most common antibiotic classes prescribed were cephalosporins (43% of claims; 44% inappropriate), penicillins (28% of claims; 44% inappropriate), macrolides (19% of claims; 52% inappropriate), and fluoroquinolones (9% of claims; 40% inappropriate). Nearly 5% of antibiotics were prescribed in intravenous formulations. The most common prescribers were General/Family Practice physicians (53% of claims; 50% inappropriate), followed by Pediatrics (18.6% of claims; 36% inappropriate) and Internal Medicine (14.1% of claims; 44% inappropriate).
  
  
  CONCLUSIONS
  There is a high rate of inappropriate antibiotic prescription for acute URTIs in the private health care sector in the State of Qatar. Further studies are needed to determine the population-based rates across the country. Interventions to decrease inappropriate use in such settings are urgently needed.
authors.affiliation: Hamad Healthcare Quality Institute, PO Box 3050, Doha, Qatar; Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medical College, Doha, Qatar and New York, USA. Electronic address: aabutt@hamad.qa.
authors.forename: Adeel Ajwad
authors.initials: AA
authors.lastname: Butt
authors.affiliation: Hamad Healthcare Quality Institute, PO Box 3050, Doha, Qatar.
authors.forename: Cristina S
authors.initials: CS
authors.lastname: Navasero
authors.affiliation: Hamad Healthcare Quality Institute, PO Box 3050, Doha, Qatar.
authors.forename: Bright
authors.initials: B
authors.lastname: Thomas
authors.affiliation: Ministry of Public Health, Doha, Qatar.
authors.forename: Salih Al
authors.initials: SA
authors.lastname: Marri
authors.affiliation: Ministry of Public Health, Doha, Qatar.
authors.forename: Huda Al
authors.initials: HA
authors.lastname: Katheeri
authors.affiliation: Qatar University, Doha, Qatar.
authors.forename: Asmaa Al
authors.initials: AA
authors.lastname: Thani
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Abdullatif Al
authors.initials: AA
authors.lastname: Khal
authors.affiliation: National Health Insurance Corporation, Doha, Qatar.
authors.forename: Tasnim
authors.initials: T
authors.lastname: Khan
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Abdul-Badi
authors.initials: AB
authors.lastname: Abou-Samra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010406:Penicillins / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017149:Private Sector / Q000706:statistics & numerical data*; D011780:Qatar / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins
keywords: Antibiotics; Inappropriate; Upper respiratory tract