Türkiye’de Akut Gastroenterit Vakalarında Reçete Bilgi Sistemine Göre Reçeteleme Paterninin İzlenmesi ve Ankara İli Örneğinde Antibiyotik Reçetelenme Durumunun Değerlendirilmesi

Abstract

The aim of this study was to draw attention to the prescribing of antibiotics in Acute Gastroenteritis(AGE), a common infectious disease. In the first part of the study, a general evaluation of the protocols established by Family Physicians in Turkey between 2013-2018 with the diagnosis of AGE was made. In the second part, the protocols within the province of Ankara between 2016-2018 were evaluated in detail. It was evaluated whether there was an indication of antibiotic use according to the guidelines only for the diagnosis of AGEs, and the verification of possible associations between some features in the prescriptions and the presence of antibiotics was performed by path analysis. While the percentage of prescriptions containing antibiotics in Turkey was 62.6% in 2013, this value decreased to 44.3% in 2018. It was determined that the percentage of prescriptions containing antibiotics increased in summer months. Southeastern Anatolia Region had the highest percentage of prescription containing antibiotics. Male physicians (65.1%-46.7%) had higher percentage of antibiotic prescriptions than female physicians (56.2%-38.1%); general practitioners (63.1%-44.4%) had higher percentage than specialists (51.7%-33.9%), and male patients (63.4%-44.6%) had higher percentage than female patients (61.6%-44.0%). According to Ankara data increasing the age of the physician reduces the rate of irrational antibiotic prescribing, while increasing the age of the patient increases it. Compared to reference categories, irrational antibiotic prescribing increases by 1,275 times in summer, 1,075 times in autumn, 1,354 times in the year of 2016, 1,118 times in the year of 2017, male physicians by 1,391 times, and male patients by 1,030 times. The place where the physician works changes the association between specialty and irrational antibiotic prescribing. Irrational antibiotic prescribing is 2,185 times higher among specialist physicians working in non-central districts, 1,508 times higher among general practitioners working in central districts, and 2,219 times higher among general practitioners working in non-central districts. In the association between the irrational antibiotic prescription and being a male physician the non-central district had a mediation role. It is thought that it would be useful to consider the region, physician and patient characteristics in planning corrective actions on antibiotic prescribing for AGEs. It is thought that it is important to consider the region, physician and patient characteristics in planning corrective actions regarding antibiotic prescribing in AGE diagnoses.