Unnecessary antimicrobial prescribing for upper respiratory tract infections in children in Pietermaritzburg, South Africa|
Mathibe, Lehlohonolo John & Zwane, Nonhle Perseverance
Background: Acute upper respiratory tract infections (URTIs) are contagious diseases of the upper airways, but they are
self-limiting in nature. Therefore, antimicrobial-use for the majority of the URTIs is considered inappropriate. Unfortunately,
globally, antimicrobials are still being prescribed for the treatment of URTIs, especially in children. However, there is
insufficient evidence on the causes of this phenomenon in South Africa.
Objective: To investigate whether the parents/guardians accompanying children with URTIs expected/influenced physicians
and/or nurses to prescribe antibiotics.
Methods: This was a prospective descriptive and explorative questionnaire-based study. Participants were guardians who
accompanied children aged five years and below, diagnosed with acute URTIs.
Findings: Three hundred and six parents/guardians participated in this study. Seventy six percent (n=233) of participants
received antibiotics for URTIs for their children, and 67% (n=156) of these did not make requests for antimicrobial therapy.
On overall, there was a statistically significant (p < 0.0001) chance (with OR of 5.9; 95% CI, 2.4 – 14.2) for receiving antibiotics
for URTIs without a request.
Conclusion: Physicians and other healthcare providers need education on rational prescribing of antimicrobials, and to
implement evidence-based standard treatment guidelines, to reduce inappropriate use of antibiotics in children with self-limiting
Antibiotics; antimicrobials; prescribing; upper respiratory tract infections; children.