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cohort·epidemiology, public health, family medicine, infectious disease, internal medicine·PMC10135213

Prescribing Antibiotics in Public Primary Care Clinics in Singapore: A Retrospective Cohort Study

Antibiotics · 8 authors, 4 centres

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TL;DR

A total of 141,944 oral and 108,357 topical antibiotics were prescribed, yielding overall prescription rates of 4.33% and 3.31%, respectively.

Full summary

597 CHARS

A total of 141,944 oral and 108,357 topical antibiotics were prescribed, yielding overall prescription rates of 4.33% and 3.31%, respectively. Respiratory antibiotic prescriptions fell by 84% over the study period, shifting the leading indication from respiratory conditions to skin and soft tissue conditions by 2021. Use of WHO Access group antibiotics increased from 85.6% to 92.1%. On multivariate analysis, female gender, diabetes mellitus, chronic kidney disease, and having an accredited family physician were significantly associated with antibiotic prescriptions for undefined conditions.

STUDY TYPE

cohort

SPECIALTY

epidemiology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10135213

Prescribing Antibiotics in Public Primary Care Clinics in Singapore: A Retrospective Cohort Study

Antibiotics

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ABSTRACT

Abstract Background: Antibiotic prescription practices in primary care in Singapore have received little scholarly attention. In this study, we ascertained prescription prevalence and identified care gaps and predisposing factors. Methods: A retrospective study was conducted on adults (>21 years old) at six public primary care clinics in Singapore. Prescriptions >14 days were excluded. Descriptive statistics were used to showcase the prevalence data. We used chi-square and logistic regression analyses to identify the factors affecting care gaps. Results: A total of 141,944 (4.33%) oral and 108,357 (3.31%) topical antibiotics were prescribed for 3,278,562 visits from 2018 to 2021. There was a significant reduction in prescriptions ( p < 0.01) before and after the pandemic, which was attributed to the 84% reduction in prescriptions for respiratory conditions. In 2020 to 2021, oral antibiotics were most prescribed for skin (37.7%), genitourinary (20.2%), and respiratory conditions (10.8%). Antibiotic use in the “Access” group (WHO AWaRe classification) improved from 85.6% (2018) to 92.1% (2021). Areas of improvement included a lack of documentation of reasons for antibiotic use, as well as inappropriate antibiotic prescription for skin conditions. Conclusion: There was a marked reduction in antibiotic prescriptions associated with the onset of the COVID-19 pandemic. Further studies could address the gaps identified here and evaluate private-sector primary care to inform antibiotic guidelines and the local development of stewardship programs. Keywords: antibiotic, general practice, antibiotic usage, antibiotic prescription rates, antibiotic prevalence, primary care, antimicrobial resistance

CITATION EXPORT

Sky Wei Chee Koh, Vivien Min Er Lee, Si Hui Low et al.. Prescribing Antibiotics in Public Primary Care Clinics in Singapore: A Retrospective Cohort Study. Antibiotics. (2023). https://doi.org/10.3390/antibiotics12040762

AUTHORS

8 · 4 CENTRES

Sky Wei Chee Koh, Vivien Min Er Lee, Si Hui Low, Wei Zhi Tan, José María Valderas, Victor Weng Keong Loh, Meena Sundram, Li Yang Hsu

1National University Polyclinics, National University Health System, Singapore 609606, Singapore
2Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
3School of Biological Sciences, Nanyang Technological University, Singapore 637551, Singapore
4Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore