Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan
Abstract Objective: To assess the impact of treatment guidelines on the trends of outpatient antibiotic prescription among pediatric and adult patients at a cancer center in Pakistan. Design: Retrospective observational study conducted between July 1st 2018 and July 31st 2023. Methods: We dete...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25000026/type/journal_article |
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| _version_ | 1850025234489409536 |
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| author | Salma Abbas Seemal Aslam Sara Batool Mahnoor Zafar Sadia Khaliq Momal Fatima Iraj Shehzad Muhammad Arslan Iqra Attiq Muhammad Shehbaz Anum Khan Muhammad Ali Raza Hamza Zulfiqar Ahsan Mahmood Faisal Sultan |
| author_facet | Salma Abbas Seemal Aslam Sara Batool Mahnoor Zafar Sadia Khaliq Momal Fatima Iraj Shehzad Muhammad Arslan Iqra Attiq Muhammad Shehbaz Anum Khan Muhammad Ali Raza Hamza Zulfiqar Ahsan Mahmood Faisal Sultan |
| author_sort | Salma Abbas |
| collection | DOAJ |
| description |
Abstract
Objective:
To assess the impact of treatment guidelines on the trends of outpatient antibiotic prescription among pediatric and adult patients at a cancer center in Pakistan.
Design:
Retrospective observational study conducted between July 1st 2018 and July 31st 2023.
Methods:
We determined the indication for antibiotics and the frequency of guideline-discordant prescriptions for upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), urinary tract infection (UTI), and diarrhea. The χ2 test was used to assess the impact of treatment guidelines on antibiotics prescribed for these indications.
Results:
The top indications for antibiotic prescription were skin and skin structure infection (SSSI) (n = 5159; 21.5%), URTI (n = 2760; 11.5%) and UTI (n = 2686; 11.2%). Amoxicillin-clavulanate (n = 7964; 33.3%), was the most frequently prescribed antibiotic. A large proportion of antibiotic prescriptions for URTI, diarrhea, UTI, and LRTI were either inappropriate (n = 6695; 86.5%) or unnecessary (n = 5534; 71.5%). Results revealed a statistically significant decline in the proportion of inappropriate antibiotics for UTI (91.3% vs 84.0%; P ≤ .001) and diarrhea (92.6% vs 87.0%; P = .031) and unnecessary antibiotics for diarrhea (90.2% vs 83.2%; P = .016) with the introduction of treatment guidelines. We noted a higher proportion of unnecessary prescriptions for LRTI (41.7% vs 31.7%; P = .003) and inappropriate antibiotics for UTI (95.1% vs 87.4%; P = .011) for pediatric patients.
Conclusion:
Misuse of outpatient antibiotics is common. Diarrhea, URTI, UTI, and LRTI are high-priority conditions for outpatient oncology-focused prescriber education and stewardship interventions.
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| format | Article |
| id | doaj-art-ce8dfe801045403e93f5e90173f0fa65 |
| institution | DOAJ |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-ce8dfe801045403e93f5e90173f0fa652025-08-20T03:00:54ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.2Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in PakistanSalma Abbas0https://orcid.org/0000-0002-0899-8712Seemal Aslam1https://orcid.org/0009-0008-6902-7531Sara Batool2Mahnoor Zafar3Sadia Khaliq4Momal Fatima5Iraj Shehzad6Muhammad Arslan7Iqra Attiq8Muhammad Shehbaz9Anum Khan10Muhammad Ali Raza11Hamza Zulfiqar12Ahsan Mahmood13Faisal Sultan14https://orcid.org/0000-0002-2618-988XDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Acute Medicine and Infectious Diseases, Birmingham Heartlands Hospital, Birmingham, EnglandDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, PakistanDepartment of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Punjab, Pakistan Abstract Objective: To assess the impact of treatment guidelines on the trends of outpatient antibiotic prescription among pediatric and adult patients at a cancer center in Pakistan. Design: Retrospective observational study conducted between July 1st 2018 and July 31st 2023. Methods: We determined the indication for antibiotics and the frequency of guideline-discordant prescriptions for upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), urinary tract infection (UTI), and diarrhea. The χ2 test was used to assess the impact of treatment guidelines on antibiotics prescribed for these indications. Results: The top indications for antibiotic prescription were skin and skin structure infection (SSSI) (n = 5159; 21.5%), URTI (n = 2760; 11.5%) and UTI (n = 2686; 11.2%). Amoxicillin-clavulanate (n = 7964; 33.3%), was the most frequently prescribed antibiotic. A large proportion of antibiotic prescriptions for URTI, diarrhea, UTI, and LRTI were either inappropriate (n = 6695; 86.5%) or unnecessary (n = 5534; 71.5%). Results revealed a statistically significant decline in the proportion of inappropriate antibiotics for UTI (91.3% vs 84.0%; P ≤ .001) and diarrhea (92.6% vs 87.0%; P = .031) and unnecessary antibiotics for diarrhea (90.2% vs 83.2%; P = .016) with the introduction of treatment guidelines. We noted a higher proportion of unnecessary prescriptions for LRTI (41.7% vs 31.7%; P = .003) and inappropriate antibiotics for UTI (95.1% vs 87.4%; P = .011) for pediatric patients. Conclusion: Misuse of outpatient antibiotics is common. Diarrhea, URTI, UTI, and LRTI are high-priority conditions for outpatient oncology-focused prescriber education and stewardship interventions. https://www.cambridge.org/core/product/identifier/S2732494X25000026/type/journal_article |
| spellingShingle | Salma Abbas Seemal Aslam Sara Batool Mahnoor Zafar Sadia Khaliq Momal Fatima Iraj Shehzad Muhammad Arslan Iqra Attiq Muhammad Shehbaz Anum Khan Muhammad Ali Raza Hamza Zulfiqar Ahsan Mahmood Faisal Sultan Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan |
| title_full | Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan |
| title_fullStr | Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan |
| title_full_unstemmed | Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan |
| title_short | Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan |
| title_sort | examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in pakistan |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25000026/type/journal_article |
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