Antibiotic Prescribing Practices of Clinical Officers for Patients with Upper Respiratory Tract Infection at Kiambu County, Kenya
| dc.contributor.author | Murigi, Kevin Wambua | |
| dc.date.accessioned | 2025-02-18T07:07:49Z | |
| dc.date.available | 2025-02-18T07:07:49Z | |
| dc.date.issued | 2024-11 | |
| dc.description | A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Masters in Medicine (Family Medicine) in the School of Health Sciences of Kenyatta University November, 2024 | |
| dc.description.abstract | According to the World Health Organization (WHO), over 50% of all medicines are prescribed, dispensed or sold inadvertently, and more than half of all patients take them incorrectly. Antibiotics are the most routinely prescribed medications. Antibiotics are incorrectly prescribed for viral illnesses and broad-spectrum antibiotics are being used in place of narrow-spectrum antibiotics. Antibiotic resistance has emerged because of incorrect antimicrobial treatment and misuse of antibiotics. Findings from studies have shown an association between prescriber factors, patient factors, institutional factors and antibiotic prescribing. There is scarce data in Kenya about antibiotic prescribing practices, factors affecting antibiotic prescribing, how it varies between different healthcare workers and the mechanism by which interventions are effective. The goal of this study was to figure out antibiotic use among patients with upper respiratory tract infections in Kiambu County. The study design was a cross-sectional hospital-based study. The study area was one public level 5 hospital, five public level 4 hospitals and 14 public health centers within Kiambu County. Data was collected in the form of a modified WHO prescribing indicators checklist and using questionnaires. The WHO prescribing indicators checklist on rational use of medicine was used to collect data from 600 patient encounters. The questionnaire was used to collect data from 36 clinicians working in the outpatients. The data from the checklist included the total number of medications prescribed per encounter, the number of encounters with antibiotics, the proportion of generic antibiotics prescribed, the proportion of antibiotics prescribed from the Kenya Essential Medicines List (KEML), the antibiotic prescribed, its dose, frequency, duration and indication. The data from the questionnaire included prescriber age, gender, level of education, work experience, laboratory availability, availability of antibiotics and availability of guidelines. An Open Data Kit (ODK) was used to collect the WHO data collection checklist. Data was imported into a Microsoft Excel sheet from the ODK server then exported to a Statistical Package for Social Science (SPSS) version 22.0 for further cleaning and analysis. Descriptive statistics of frequencies and percentages were used to summarize categorical variables, and median (interquartile range) was used in case of continuous variables. Logistic regression was employed to find the association between antibiotic prescribing and the prescribing factors. Odds ratio with 95% confidence interval was reported in the logistic regression analysis. All analysis were considered significant when p < 0.05. Antibiotics were prescribed in 78% of patient encounters, 96.8% of encounters with an antibiotic had a generic antibiotic, and 96.6% of antibiotics prescribed were from the KEML. Over 91% of antibiotics prescribed were the right dose, 98.3% were the right frequency, 75.2% were the right duration, only 23.8% was the right indication. Availability of antibiotics p=0.026 and availability of hospital guidelines p=0.012 were significantly associated with rational antibiotic prescribing. Patient fever significantly affected rational antibiotic prescribing (OR 4.7, 95% CI 2.49, 8.89, p=<0.001), patient age and gender did not significantly affect antibiotic prescribing. Prescriber gender, p=0.63, age, p=0.92, education level, p=0.99 and work experience, p=0.22 did not significantly affect antibiotic prescribing. | |
| dc.description.sponsorship | Kenyatta University | |
| dc.identifier.uri | https://ir-library.ku.ac.ke/handle/123456789/29615 | |
| dc.language.iso | en | |
| dc.publisher | Kenyatta University | |
| dc.title | Antibiotic Prescribing Practices of Clinical Officers for Patients with Upper Respiratory Tract Infection at Kiambu County, Kenya | |
| dc.type | Thesis |