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Critical Care

, 11:P85 | Cite as

Antibiotic prescribing practices in public and private-sector intensive care units in South Africa

  • S Bhagwanjee
  • H Perrie
  • J Scribante
  • F Paruk
Poster presentation

Keywords

Health Care Intensive Care Unit Private Sector Health Care System Emergency Medicine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Considerable variability exists in antibiotic prescribing practices. A dichotomous health care system in South Africa has created the opportunity for vastly differing practices. As part of a national 1-day sepsis prevalence study (PISA), a review was undertaken of antibiotic prescribing practices in public and private-sector ICUs.

Method

Following appropriate institutional approval, 43 ICUs were selected using the proportional probability sampling technique. This was applied to a national database of ICUs. Every seventh bed was selected from all the serially placed units. Antibiotic therapy was reviewed by two independent reviewers. Data collected included the appropriateness of pretherapy cultures, postculture modification of therapy, duration of therapy and, finally, impact of appropriate antibiotic choice on mortality.

Results

See Table 1. Public-sector practice is better with respect to pretherapy sampling and duration of treatment. Better modification of treatment occurs in the private sector.
Table 1

Appropriateness of antibiotic therapy

Intervention

Sector

Number

Percentage

Preculture sampling

Private

27/62

43*

 

Public

73/120

61

Modification of antibiotics

Private

49/61

80

 

Public

18/27

67

Duration of treatment

Private

25/134

19*

 

Public

26/49

53

*P < 0.05.

Overall mortality of both groups was 10/82 (12%) when antibiotic choice was appropriate compared with 28/90 (31%) (P < 0.05) when therapy was inappropriate.

Conclusion

There are significant differences in antibiotic prescribing practices when public and private sectors are compared. Appropriate early antibiotic prescriptions reduce mortality. Attention to education and systems that address prescribing practices is indicated.

Copyright information

© BioMed Central Ltd. 2007

Authors and Affiliations

  • S Bhagwanjee
    • 1
  • H Perrie
    • 1
  • J Scribante
    • 1
  • F Paruk
    • 1
  1. 1.University of the Witwatersrand and the CCSSAJohannesburgSouth Africa

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