Antibiotics Use Evaluation in Acute Diarrhea of Hospital in Tak Province

Abstract

Background: Different antibiotic prescribing guidelines and geographic location (western and eastern sides of Tak Province) may influence antibiotic prescribing in acute diarrhea.

Method: A retrospective quantitative study was conducted using data collected from electronic medical records of outpatients with acute diarrhea at hospitals in Tak Province. The data were used to evaluate the appropriateness of antibiotic prescribing practices according to 4 guidelines: 1) ASU (antibiotic smart use): National Health Security Office (NHSO), 2) RDU (rational drug use): rational drug use hospital manual, Ministry of Public Health, 3) Management guideline of acute diarrhea in adult: the Gastroenterological Association of Thailand, and 4) Clinical practice guideline for acute diarrhea in children 2019: Thai Society of Pediatric Gastroenterology and Hepatology. The results were compared using chi-square statistical tests to assess differences between the guidelines and between regions.

Result: A total of 12,212 outpatient visits were included, categorized into three age groups: ≤ 5 years, 6-15 years and >15 years. The evaluation of antibiotic appropriateness according to the ASU guidelines yielded higher percentages compared to the other guidelines-specifically, 73.50%, 73.20%, and 64.00% for each age group, respectively. Statistically significant differences in the evaluation of antibiotic appropriateness between ASU and RDU guidelines and between ASU and the guideline of Thai Society of Pediatric Gastroenterology and Hepatology were observed in the 6-15 years age group, and between ASU and the guideline of the Gastroenterological Association of Thailand were observed in > 15 years age group (p-value < 0.05). When comparing the appropriateness of antibiotic use between hospitals in the western and eastern regions of Tak Province, it was found that hospitals in the eastern regions had significantly higher appropriateness of antibiotic use across all 4 guidelines in all age groups (p-value < 0.05).

Conclusion: This study found that, across all age groups, the ASU guidelines resulted in higher appropriateness of antibiotics use compared to the other guidelines. Additionally, hospitals in the eastern regions of Tak Province demonstrated significantly higher appropriateness in antibiotic prescribing practices across all 4 guidelines than those in the western regions.