Assessment of prescribing practices for respiratory tract infections in public health facilities, Jinja City, Uganda, June 2022–May 2023

Abstract

Background: Rational drug use ensures that medications are prescribed based on clinical needs, appropriate dosages, and for the right duration, minimizing healthcare costs. Irrational antibiotic use is a key driver of antibiotic resistance (ABR) emergence. We evaluated the conformance of drug prescriptions to the World Health Organization (WHO) prescribing indicators among patients with respiratory tract infections (RTIs) attending public health facilities in Jinja City, Uganda. Methods: A retrospective observational study was conducted across 11 public health facilities in Jinja City, Eastern Uganda, from June 1, 2022, to May 31, 2023. Patient records of those diagnosed with RTIs were selected using systematic random sampling. Several prescribing indicators were assessed, including the number of drugs prescribed per patient encounter, the percentage of encounters with antibiotics, the percentage of drugs from the essential drugs list, the percentage of drugs prescribed by generic name, and the percentage of encounters with injectable medications. Data were analyzed for compliance with WHO prescribing standards. Results: Three indicators met or were close to WHO targets: the average number of drugs prescribed per patient (2.7, WHO target<3), the percentage of encounters with injections prescribed (3.0%, WHO target≤10%), and the percentage of drugs from the essential drugs list (93.4%, WHO target 100%). However, two indicators did not meet WHO recommendations: the percentage of encounters with antibiotics prescribed (79.8%, WHO target<30%) and the percentage of drugs prescribed by generic name (79.5%, WHO target 100%), suggesting irrational prescribing practices. Among patients prescribed antibiotics, most received only one antibiotic (89.1%). Conclusion: This study revealed gaps in adherence to WHO prescribing standards, particularly regarding excessive antibiotic prescriptions for RTIs. These irrational prescribing practices may contribute to the emergence of ABR. There is a need for targeted interventions to promote rational drug use and improve prescribing practices across health facilities in the region.