Original Research

Antibiotic prescription for HIV-positive patients in primary health care in Mozambique: A cross-sectional study

Candido Faiela, Esperanca Sevene
Southern African Journal of Infectious Diseases | Vol 37, No 1 | a340 | DOI: https://doi.org/10.4102/sajid.v37i1.340 | © 2022 Candido Faiela, Esperanca Sevene | This work is licensed under CC Attribution 4.0
Submitted: 20 September 2021 | Published: 28 February 2022

About the author(s)

Candido Faiela, Department of Biological Science, Faculty of Science, Eduardo Mondlane University, Maputo, Mozambique; and, Department of Physiological Science, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Esperanca Sevene, Department of Physiological Science, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique


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Abstract

Background: Antibiotic overuse is a major public health challenge worldwide and it can result in the emergence and spread of drug resistance. In Mozambique, there are limited data related to primary care physicians’ antibiotic prescription patterns. The aim of this study was to assess the antibiotic prescription patterns for HIV- positive patients in primary health care.

Methods: A prospective cross-sectional quantitative study was conducted in eight primary health care units in Southern Mozambique. The study was based on recording outpatient prescriptions using a structured questionnaire. Three hundred and sixty-nine prescriptions and clinical records of HIV-positive patients from 31 prescribers were assessed. A total of eight general practitioners, 13 medical technicians and 10 nurses participated.

Results: Antibiotics were used in 65.9% of prescriptions, with an average of 0.9 antibiotics per prescription. Of a total of 334 prescribed antibiotics, 69.8% were for the treatment of infections and 30.2% for prophylaxis. Penicillin (29.2%), sulphonamides (19.7%), and quinolones (16.3%) were the most prescribed classes of antibiotics for treatment. For prophylaxis, only sulphonamides (93.1%) and macrolides (6.9%) were prescribed. The diagnosis was the only variable that had a significant association with antibiotic prescription (p < 0.001). Most of penicillins (68.0%) and sulphonamides (21.4%) were prescribed to treat infections related to the respiratory tract.

Conclusion: The prescription of antibiotics was high and influenced by patient clinical conditions. Antibiotics were prescribed either for treatment or prophylaxis of infections, mostly to treat respiratory tract infections. Prescribers should be encouraged to adopt a rational use of antibiotics to reduce unnecessary prescriptions.


Keywords

prescription; antibiotics; HIV; primary health care; drug resistance; drug interactions

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