Saudi Journal of Emergency Medicine

Original Article
SJEMed. 2022; 3(1): 017-024

Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study

Authors: Sania Zia, Rasha AL-khateeb, Muna Aljallaf, Manal Yaslam, Syed Ibrahim Muneeb, Firas AlNajjar, Laila AlDabal.

View PDF HTML Fulltext DOI: 10.24911/SJEMed/72-1634136332

Abstract

Background: Community-acquired bacterial pneumonia (CAP), skin and soft-tissue infection (SSTI), and urinary tract infection (UTI) are frequently encountered in the emergency department (ED) but treated with varied antibiotic regime. We aimed to assess the antibiotic prescribing practice in ED for CAP, SSTI, and UTI based on hospital guideline adherence (choice, dose, and duration of antibiotic). To the authors’ knowledge, this is the first study to address this issue by a dual model of physician survey and prescription review from the ED perspective. Methods: One hundred ED physicians were surveyed followed by a cross-sectional study of 300 uncomplicated adult ED outpatient infections (100 CAP, 100 SSTI, and 100 UTI) from August 2017 to August 2018 retrospectively at Rashid Hospital in Dubai. Results: Most of the participants (91%) had never been in an antibiotic stewardship. 30%, 52%, and 48% were not aware of CAP, SSTI, and UTI hospital guidelines, respectively. Majority (58%) of physicians preferred a parenteral first dose of empirical therapy. Mean age of patients was 45.14 ± 17.8 years and the majority were males (55.7%). The most frequently prescribed antibiotics were β-lactams (n = 157, 52.3%, 95% CI 46.5-58.1). Non-adherence to guidelines was noted in 59% (95% CI 53.2-64.6) of cases; the frequency was highest for UTI (75%), followed by CAP (71%) and SSTI (31%). The most common cause of non-adherence was incorrect drug choice (n = 126, 42%,95% CI 36.3-47.8). Conclusion: High rates of physician non-compliance to guidelines for outpatient empirical antibiotic prescriptions exists in the ED with incorrect drug choice being the most common cause.

Keywords:   Antibiotic; Resistance; Prescription; Emergency; Guideline; Stewardship.


© Copyright: Author(s)

Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study


Authors
Sania Zia
Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Rasha AL-khateeb
Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Muna Aljallaf
Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Manal Yaslam
Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Syed Ibrahim Muneeb
Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Firas AlNajjar
Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Laila AlDabal
Department of Internal Medicine, Infectious Disease Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
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Correspondence to:
. Sania Zia, Emergency Department, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.; sania1029@gmail.com

Publication history
Received 13 Oct 2021
Accepted 06 Dec 2021
Published online 31 Dec 2021
Published in print 07 Mar 2022

How to cite this article

Pubmed Style

Zia S, AL-khateeb R, Aljallaf M, Yaslam M, Muneeb SI, AlNajjar F, AlDabal L. Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. SJEMed. 2022; 3(1): 017-024. doi:10.24911/SJEMed/72-1634136332


Web Style

Zia S, AL-khateeb R, Aljallaf M, Yaslam M, Muneeb SI, AlNajjar F, AlDabal L. Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. https://www.sjemed.com/?mno=132630 [Access: July 02, 2022]. doi:10.24911/SJEMed/72-1634136332


AMA (American Medical Association) Style

Zia S, AL-khateeb R, Aljallaf M, Yaslam M, Muneeb SI, AlNajjar F, AlDabal L. Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. SJEMed. 2022; 3(1): 017-024. doi:10.24911/SJEMed/72-1634136332


Vancouver/ICMJE Style

Zia S, AL-khateeb R, Aljallaf M, Yaslam M, Muneeb SI, AlNajjar F, AlDabal L. Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. SJEMed. (2022), [cited July 02, 2022]; 3(1): 017-024. doi:10.24911/SJEMed/72-1634136332


Harvard Style

Zia, S., AL-khateeb, . R., Aljallaf, . M., Yaslam, . M., Muneeb, . S. I., AlNajjar, . F. & AlDabal, . L. (2022) Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. SJEMed, 3 (1), 017-024. doi:10.24911/SJEMed/72-1634136332


Turabian Style

Zia, Sania, Rasha AL-khateeb, Muna Aljallaf, Manal Yaslam, Syed Ibrahim Muneeb, Firas AlNajjar, and Laila AlDabal. 2022. Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. Saudi Journal of Emergency Medicine, 3 (1), 017-024. doi:10.24911/SJEMed/72-1634136332


Chicago Style

Zia, Sania, Rasha AL-khateeb, Muna Aljallaf, Manal Yaslam, Syed Ibrahim Muneeb, Firas AlNajjar, and Laila AlDabal. "Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study." Saudi Journal of Emergency Medicine 3 (2022), 017-024. doi:10.24911/SJEMed/72-1634136332


MLA (The Modern Language Association) Style

Zia, Sania, Rasha AL-khateeb, Muna Aljallaf, Manal Yaslam, Syed Ibrahim Muneeb, Firas AlNajjar, and Laila AlDabal. "Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study." Saudi Journal of Emergency Medicine 3.1 (2022), 017-024. Print. doi:10.24911/SJEMed/72-1634136332


APA (American Psychological Association) Style

Zia, S., AL-khateeb, . R., Aljallaf, . M., Yaslam, . M., Muneeb, . S. I., AlNajjar, . F. & AlDabal, . L. (2022) Trends in outpatient antibiotic prescriptions by emergency physicians of a tertiary hospital in UAE: a retrospective cross-sectional study. Saudi Journal of Emergency Medicine, 3 (1), 017-024. doi:10.24911/SJEMed/72-1634136332


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