Background:

Augmentin resistance pattern of E. Coli and Klebsiella sp at HC in Kedah were above 20% in year 2017. This audit is to assess appropriateness of Augmentin prescribing in HC.

Methods:

A total of 118 prescriptions of Augmentin with the case notes for all diagnosis from 1st to 31st October 2018 in all HC in Kedah were audited. We analysed the appropriateness of Augmentin use by the indication, dosage, frequency and duration based on National Antibiotic Guidelines 2014. We compared the results between HC with and without resident Family Medicine Specialist (FMS).

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Results:

The distribution of diagnoses prescribed with Augmentin were mostly for Community Acquired Pneumonia (64%), followed by others diagnoses (17% i.e. Soft Tissue Infection, Tonsillitis, Lymphadenitis). Among all the diagnoses, 86 cases (73%) were indicated for Augmentin. The Augmentin prescriptions were equally appropriate for both HC with resident and without resident FMS (72% and 76% respectively). Majority of the prescriptions (90.7%) were from Medical Officers (MO), where 68.6% were from HC with resident FMS. However there were only 38.3% of FMS approvals for Augmentin prescribing. Those without approval, 47% of cases were not indicated.

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Conclusions:

Augmentin prescribing was appropriate for both HC with resident and nonresident FMS. The appropriateness can be improved by prescribers through adherence of standard operating procedure on prescribing Augmentin. Further audit on prescribing Augmentin including at private practice should be done in future to capture the scenario in the whole population.