Objective:
We explored the prescribing patterns of physicians in North Trinidad
in treating upper respiratory tract infections (URTI) in paediatric
patients and the appropriateness of drugs prescribed.
Methods: A retrospective observational study was conducted, with
a sample size of 523 paediatric patients, diagnosed with an URTI
during the period of June 2003 to 22 June 2005. The study was
conducted at five Primary Health Care Facilities in North Trinidad.
Results: The three most frequent URTIs diagnosed were non-specific
URTI, common cold, and acute tonsillitis in rank order. Four patterns
of prescribing were identified, (1) no drug therapy [1.9%]; (2)
antibiotic therapy alone [6.1%]; (3) antibiotic and symptomatic
therapy [53.0%]; and (4) symptomatic therapy alone [39.0%]. The,
most frequently prescribed antibiotics were penicillins (amoxicillin
[46.3%] and amoxicillin/clavulanate [5.3%]) and a macrolide (erythromycin
[6.1%]). The three symptomatic agents most frequently prescribed
were paracetamol [40.1%]; diphenhydramine [29.1%]; and normal
saline nasal drops [14.2%]. In 112 cases with swab analyses done,
of these, 98.2% revealed a growth of commensals only, while 1.8%
grew pathogenic micro-organisms. Of the cases showing commensal
growth only, 84.6% were treated with an antibiotic, 14.5% were
treated with symptomatic agents alone and 0.9% received no drug
therapy at all.
Conclusions: A large proportion of paediatric patients diagnosed
with an URTI in North Trinidad was prescribed antibiotics although
not indicated The inappropriate use of antibiotics can potentiate
the worldwide trend of antimicrobial resistance.
