{"title":"Antibiotic prescribing in public primary healthcare centres in Maseru, Lesotho.","authors":"Mapoloko A Letša, Johanita R Burger, Irma Kotzé","doi":"10.4102/sajid.v40i1.692","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Inappropriate prescribing of antibiotics is a global problem. We assessed the prescribing patterns of antibiotics in three public primary healthcare centres (PHCCs) in Maseru, Lesotho.</p><p><strong>Objectives: </strong>A cross-sectional point prevalence survey was employed using patients' prescription booklets from October 2022 to December 2022.</p><p><strong>Method: </strong>Antibiotics were categorised according to the World Health Organization (WHO) AWaRe classification and assessed by Defined Daily Dose (DDD)/100 outpatients/day to measure relative consumption of each antibiotic as a percentage of total consumption, Access-to-Watch index (AW-I) and Amoxicillin Index (A-I).</p><p><strong>Results: </strong>Of the 624 participants (median age 35 [interquartile range {IQR}: 45-26] years), 71.5% (<i>n</i> = 446) were female. Overall mean (standard deviation [s.d.]) antibiotic consumption was 1.48 (0.13) DDD/100 outpatients/day, with PHCC-1 at 1.64, PHCC-2 at 1.33 and PHCC-3 at 1.47 DDD/100 outpatients/day. The median (IQR) AW-I was 4.64 (3.42-9.45) and the A-I was 1.41 (0.87-1.95). The most frequently prescribed Access group antibiotics included amoxicillin (PHCC-2: 45.9%, overall 1.33 DDD/100 outpatients/day; PHCC-3: 24.5%, 1.47 DDD/100 outpatients/day, and PHCC-1: 23.2%, 1.64 DDD/100 outpatients/day) and doxycycline (PHCC-3: 29.9%, 1.47 DDD/100 outpatients/day, 24.1%, PHCC-2: 1.33 DDD/100 outpatients/day). Erythromycin was the most prescribed Watch group antibiotic for all PHCCs.</p><p><strong>Conclusion: </strong>High consumption of Access-group antibiotics was observed. The Watch group's antibiotic use, particularly erythromycin, requires the implementation of stewardship programmes. Results may be a baseline for establishing antibiotic stewardship in Lesotho's PHCCs.</p><p><strong>Contribution: </strong>Our study addressed the scarcity of data on antibiotic prescribing patterns in PHCCs in Lesotho using the AWaRe classification system recommended for monitoring antibiotic prescribing and promoting rational use.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"40 1","pages":"692"},"PeriodicalIF":1.4000,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886583/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Southern African Journal of Infectious Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/sajid.v40i1.692","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Inappropriate prescribing of antibiotics is a global problem. We assessed the prescribing patterns of antibiotics in three public primary healthcare centres (PHCCs) in Maseru, Lesotho.
Objectives: A cross-sectional point prevalence survey was employed using patients' prescription booklets from October 2022 to December 2022.
Method: Antibiotics were categorised according to the World Health Organization (WHO) AWaRe classification and assessed by Defined Daily Dose (DDD)/100 outpatients/day to measure relative consumption of each antibiotic as a percentage of total consumption, Access-to-Watch index (AW-I) and Amoxicillin Index (A-I).
Results: Of the 624 participants (median age 35 [interquartile range {IQR}: 45-26] years), 71.5% (n = 446) were female. Overall mean (standard deviation [s.d.]) antibiotic consumption was 1.48 (0.13) DDD/100 outpatients/day, with PHCC-1 at 1.64, PHCC-2 at 1.33 and PHCC-3 at 1.47 DDD/100 outpatients/day. The median (IQR) AW-I was 4.64 (3.42-9.45) and the A-I was 1.41 (0.87-1.95). The most frequently prescribed Access group antibiotics included amoxicillin (PHCC-2: 45.9%, overall 1.33 DDD/100 outpatients/day; PHCC-3: 24.5%, 1.47 DDD/100 outpatients/day, and PHCC-1: 23.2%, 1.64 DDD/100 outpatients/day) and doxycycline (PHCC-3: 29.9%, 1.47 DDD/100 outpatients/day, 24.1%, PHCC-2: 1.33 DDD/100 outpatients/day). Erythromycin was the most prescribed Watch group antibiotic for all PHCCs.
Conclusion: High consumption of Access-group antibiotics was observed. The Watch group's antibiotic use, particularly erythromycin, requires the implementation of stewardship programmes. Results may be a baseline for establishing antibiotic stewardship in Lesotho's PHCCs.
Contribution: Our study addressed the scarcity of data on antibiotic prescribing patterns in PHCCs in Lesotho using the AWaRe classification system recommended for monitoring antibiotic prescribing and promoting rational use.