Evaluation of the Use of Antibiotics In Respiratory Tract Infections At Giza Chest Hospital

Abstract

Fourty chest physicians and 30 patients were surveyed to study and evaluate the use of antibiotics in respiratory tract infections at Giza Chest Hospital. From that survey the following were obtained: Their qualification were MB.B.Ch (21 physicians, 52.5%), Diploma (10 physcians, 25%) and Master (9 physicians, 22.5%). Sixty percent of physicians (60%), considered text books as a main source of information about antibiotics. All of the physicians used to prescribe AB empirically. Thirty five percent the physicians (35%), considered the international guidelines as a reference for empirical AB prescription. All of the physicians considered the presence of co-morbid diseases during AB prescription. Most of the physicians considered the severity of infection as the most important factor affecting the route of ABs administration. The results also showed that thirty five percent of the physicians (35%), considered broad spectrum penicillins as the most common AB prescribed for empirical therapy. The physicians who considered 4-7 days duration for empirical therapy were (77.5%). Physicians who considered quinolones as the most frequent represcribed AB modified based on culture were (27.5%). Twenty five percent of the physicians (25%), considered quinolones as the most common AB prescribed for CAP. The physicians considered combination of ceplalosporines and quinolones as the most common AB prescribed for HAP were (27.5%(. While fourty percent of the physicians considered quinolones as the most common AB prescribed for COPD,AE. Fourty percent of the physicians depended on clinical, laboratory and radiological findings for AB prescription, especially purulence of sputum and sputum culture and sensitivity. Sixty percent of the physicians considered improvement of general condition as the most important factor determining the efficacy of AB prescribed. Three to five days duration was enough to assess the efficacy of AB prescribed. Fifty five percent of the physicians ordered sputum culture and sensitivity in case the prescribed AB was ineffective. The study showed that the majority of the physicians used to make sure that the prescribed AB was the one actually given to the patient. Most of the physicians used to ask the patient before prescribing the AB if he was sensitive to certain AB. Sixty percent of the physicians used to ask the patient about the AB history in the last 3 months. Fourty percent of the physicians, their AB prescription decision might be sometimes affected by the patient. The study was conducted on 30 patients. Ten patients were admitted in the R.I.C.U. and the other 20 patients were admitted in the ward of the hospital. Twenty (67%) were males while 10 (33%) were females. The age group 35-80 years with the mean age = 55.7 years. Most of patients were febrile and had cough and expectoration, worsening of dyspnea, co-morbid diseases, increased respiratory rate, sonorous rhonchi and coarse crepitation on auscultation.