Antimicrobial prescribing patterns in a group of private primary health care clinics in South Africa

The aim of this study was to investigate the prescribing of antimicrobials in private primary health care in South Africa. A retrospective drug utilisation study was conducted on data obtained from the database of nine private primary health care clinics for the year 2001. Antimicrobials were classified pharmacologically and their usage analysed according to number of patients and consultations, age groups, gender, diagnoses and cost. Of the 83 655 patients, 49 772 (59.50%) were female and 33 650 (40.22%) males. No gender was indicated in 233 (0.28%) of the cases. Medicine items (n = 515 976) were prescribed costing R1 716 319. Of these, 18.69% (n = 96 421) were antimicrobials costing R1 045 108 (60.89%). Antimicrobials were prescribed in 72% of the consultations. The antimicrobials that were the most often prescribed were penicillins (38.17%), sulphonamides (22.49%), antiprotozoals (9.88%) and tetracyclines (9.34%) for diagnoses such as viral-influenza, upper-respiratory infections, acute-bronchitis and acute-sinusitis. Antibiotics prescribed for viral diseases indicated inappropriate use because these infections are caused by non-bacterial agents, and thus are self-limiting. Therefore antibiotics were neither necessary nor appropriate. Further investigations should be done on standard antimicrobial treatment-guidelines in private primary health care settings in South Africa.