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TJFMPC. 2020; 14(1): 87-95

Rational Use of Antibiotics By Family Physicians in Turkey During Primary Healthcare Service: A Cross-Sectional Analysis Through The Prescription Information System

Fatma İşli1, Mesil Aksoy1, Selda Emre Aydıngöz2, Esma Kadı1.

Objectives: Ensuring the rational drug use has become one of the primary targets of health policies of countries. The drug use, which may be affected by many factors, should be regularly followed up by using scientific methods. In this context, determining the prescribing practices of physicians is the first step to define the measures to be taken against irrational drug use. In this study, we aimed to determine the rational use of antibiotics by family physicians in all provinces of Turkey for evaluation of current antibiotic pattern of family physicians across the country and between provinces. Methods: This was a retrospective descriptive study in which e-prescription data of family physicians during 2017 were obtained through the Prescription Information System (PIS). The number and percentage of prescriptions including antibiotics were determined, and the mostly preferred antibiotics in terms of number of items/boxes/costs were listed. Ten most commonly prescribed antibiotics were given for Turkey and its provinces. Results: In 2017, 22,778 family physicians entered at least one protocol (procedure) into the database through PIS across Turkey. The total number of protocols entered was 282,044,546 of which 50.21% (141,625,433) was prescription protocols. Of all the prescriptions written by family physicians in Turkey, 24.97% includes at least one antibiotic. When provinces were compared according to antibiotic prescription rates, Mardin was the first with 38.09% (357,950/939,856) followed by 35.72% (637,640/1,785,088) in Sanliurfa and 35.23% (2,109,931/5,988,772) in Adana. The three provinces with the lowest antibiotic prescription rates were Edirne (16.05%; 169,955/1,058,960), Yozgat (16.25%; 100,216/616,531) and Artvin (16.37%; 40,358/246,497). Antibiotics constituted 7.43% (n=29.284.158) of all of the drugs items in prescriptions, and total antibiotic cost is 3.45% (554.866.690 TL) of the total drug cost. Based on the number of items in the prescriptions, the most commonly prescribed antibiotics were amoxicillin and enzyme inhibitor, clarithromycin, and cefuroxime. Conclusion: This is the most comprehensive study examining the prescriptions of all family physicians for a year across Turkey. The results of the study showed that one fourth of prescriptions written by family physicians contain antibiotics. This rate is even higher in the south and southeastern regions. Mostly, broad-spectrum antibiotics are prescribed. Further research and training activities are needed to achieve the objectives of rational drug use for antibiotic prescribing in Turkey.

Key words: Family Physicians; Rational Use of Antibiotics; Primary Healthcare Service

Article Language: Turkish English

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