ABSTRACTS

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ANTIBIOTIC PRESCRIBING IN PRIMARY CARE

A survey of urban general practice consultations revealed overall antibiotic prescribing rate of 33.1%.¹ In contrast, the overall antibiotic prescribing rate in a large public primary care clinic (Klinik Kesihatan Seremban) was 16%.² The antibiotic prescribing rates for upper respiratory tract infection (URTI) for the general practice and public primary care clinics were 68.4% and 26%, respectively. The commonest antibiotics prescribed for URTI were amoxycillin (in general practice) and erythromycin (in public primary care clinic). The use of penicillin V was rare in both settings.

While there may be bones to be picked in the methodology of both surveys, these studies suggest overuse of antibiotics in Malaysian primary care setting, in particular for URTI - an infection that is primarily viral in origin. Narrow-spectrum antibiotic (penicillin V) is not favoured by the primary care doctors. The use of broad-spectrum antibiotics (such as erythromycin and amoxycillin) is less

appropriate as they are more closely linked to the emergence of antibiotic resistance.

As we decry the suboptimal prescribing practice, we are fully aware of the pressure faced by the frontline physicians in busy clinics - it is always easier to prescribe the antibiotics rather than spending precious time dissuading the demanding patients. Perhaps we need to focus more on effective symptomatic relief.

1. Teng CL, Leong KC, Aljunid SM, Cheah M. Antibiotic prescription in upper respiratory tract infections. Asia-Pacific Family Medicine. 2004;3(1,2) [Full text]
2. Teng CL, Achike FI, Phua KL, et al. General and URTI-specific antibiotic prescription rates in a Malaysian primary care setting. Int J Antimicrob Agents. 2004 Nov;24(5):496-501 [PubMed]

 Reprints request: Assoc Prof CL Teng, Department of Family Medicine, IMU Clinical School, International Medical University, 70300 Seremban. Email: tengcl@gmail.com