Study spotlights overuse of broader-spectrum antibiotics in Saudi Arabia
An analysis of dental and pediatric primary care practices in Saudi Arabia found higher prescribing of broader-spectrum antibiotics and poor adherence to antibiotic prescribing guidelines, researchers reported yesterday in the American Journal of Infection Control.
The retrospective cross-sectional study, conducted from May through November 2020 at 24 primary healthcare centers in Saudi Arabia, assessed antibiotic prescribing patterns at family medicine and dental practices using the World Health Organization AWaRe (Access, Watch and Reserve) classification system and relevant clinical guidelines. The researchers also identified factors associated with the choice of Watch-group antibiotics, which are broader-spectrum agents with a higher resistance potential.
Of the 752 antibiotic prescriptions assessed, 84% were prescribed by general practitioners and 16% by dentists, most commonly for urinary tract (12.8%) and acute respiratory tract (12.2%) infections. Compared with Access-group antibiotics, Watch-group antibiotics such as second-generation cephalosporins and macrolides were more likely to be prescribed based on the number of prescriptions (51.1% vs 48.9%) and defined daily doses (DDDs) (52.2% vs 47.8%).
The percentages of Watch-group antibiotics for children and adults were 66.7% and 42.9%, respectively. The overall adherence to clinical prescribing guidelines for children, adults, and total prescribed antibiotics was 27.2%, 64%, and 49.5%, respectively, with dental clinics demonstrating better adherence than general practices.
Multivariable logistic regression analysis found that being a child (adjusted odds ratio, [aOR], 2.89; 95% confidence interval [CI], 1.46 to 5.78), diagnosis with acute respiratory tract infection (aOR, 2.62; 95% CI, 1.03 to 6.69), and urinary tract infection (aOR, 4.69; 95% CI, 2.09 to 10.56) were associated with higher prescribing of Watch-group antibiotics.
The study authors say the findings indicate national guidelines on antibiotic use are needed in Saudi Arabia, along with a surveillance system to track antibiotic use at the national level.
"The higher proportion of prescribing of Watch-group antibiotics in this study for both children and adults is a warning sign that may reflect inappropriate awareness of the optimum antibiotic selection as well as poor adherence to guidelines," they wrote. "This result may lead to a potential increase in bacterial resistance and overuse of broad-spectrum antibiotics, which consequently increases costs and the likelihood of adverse drug reactions or lowered therapy outcomes."
Jul 19 Am J Infect Control abstract
First local dengue case in Florida prompts health alert
The Florida Department of Health this week announced a mosquito-borne illness advisory after the first local dengue illness of 2022 was identified in a Miami-Dade County resident.
Officials urged people to take preventive steps, such as draining standing water from items such as buckets and flowerpots and wearing protective clothing and mosquito repellent. They also issued a reminder about symptoms, which can be asymptomatic or mild, but can also include fever, headache, eye pain, and musculoskeletal pain.
Dengue is spread by Aedes mosquitoes. Local dengue cases aren't uncommon in south Florida. Last year Florida didn't have any reported cases, but in 2020 officials recorded 71 locally acquired cases, according to the Centers for Disease Control and Prevention (CDC).
Jul 18 Florida Department of Health statement
CDC dengue background information