Antibiotic Prescription Patterns for Upper Respiratory Tract Infections in Outpatient Qatari Population in the Private Sector

Abstract

Background: Antibiotic are often inappropriately prescribed for upper respiratory infections (URI) in the Western countries. Data on the proportion of inappropriate prescriptions are lacking from the Middle East and other developing countries. Methods: We retrieved health insurance claims for all antibiotics prescribed for URIs in the private sector in the State of Qatar between May 2014 and December 2015. During the study period, health insurance was limited to Qatari nationals. We excluded topical antibiotics. We also retrieved data on prescriber’s specialty as listed with the licensing authority. Diagnoses were classified as appropriate or inappropriate based on the likelihood of a bacterial etiology which may warrant antibiotic use. Results: There were a total of 75,733 claims during the study period. Of these, 41,556 (55%) were for an appropriate indication, while 34,177 (45%) were for an inappropriate indication. Most common antibiotic classes were cepahlosporins (43% of claims; 44% inappropriate), penicillins (28% of claims; 44% inappropriate), macrolides (19% of claims; 52% inappropriate) and fluoroquinolone (9% of claims; 40% inappropriate). Nearly 5% of antibiotics were intravenous formulations. The most common prescribers were General/Family physicians (53% of claims; 50% inappropriate), followed by Pediatrics (18.6% of claims; 36% inappropriate) and Internal Medicine (14.1 of claims; 44% inappropriate). Conclusions: There is a high rate of inappropriate antibiotic prescription for acute URIs in the private health care sector in the State of Qatar. Further studies are needed to determine the population-based rates across the country. Interventions to decrease inappropriate use in such settings are urgently needed.