EVALUATION OF ANTIBIOTIC PRESCRIPTION FOR UPPER RESPIRATORY TRACT INFECTIONS IN THE COMMUNITY PHARMACY SETTING

Objectives: To empirically classify the etiology of URTI; to study the prescription pattern for antibiotics in URTI; and to analyze the necessity and adequacy of prescribed therapy. Study design: Observational non analytical cross-sectional study. Study sites: Two community pharmacies located in Almada and in Elvas. Study population: Patients with an antibiotic prescription for a URTI (self use) and age greater than or equal to 18 years. Methods: Clinical and therapeutic data were collected during patient observation performed by a training pharmacist, and complemented with information collected through a questionnaire administered face-to-face to patients meeting the inclusion criteria and agreeing to participate. Empirical classifications were developed, one to ascertain the probability of URTI, based on Centor criteria, and another, to judge the need for antibiotic therapy, based on additional criteria considering subpopulations known to be at higher risk. Data was analyzed using the software SPSS, version 20.0. Results: The sample included 22 patients (27.3% recruited in Almada and 72.7% in Elvas). The most frequently prescribed antibiotic class was macrolides (54.5%), followed by penicillins (36.4%). In the first group, clarithromycin prevailed (66.7%) and in the second group, the more common was the association amoxicillin/clavulanic acid (75%). Considering the empirical classification developed, it was estimated that only one patient (4.5%) presented signs and symptoms suggestive of URTI with probable bacterial aetiology, and only three patients (13.6%) had an indication for antimicrobial therapy. Conclusion: The majority of patients observed were classified as having infections with apparently non-bacterial aetiology, for which the prescription of antibiotic would have been probably needless. This alerts to the overuse of antibiotics in the community setting, particularly for URTI, and its contribution to resistance.