Dr. Zaheeruddin Mohammed and Dr. Rafique Memon
The interactions between 1334 children with diarrhoea and medical professionals (32 paediatricians and 68 family physicians) were studied. More over half (51%) of GPs and 67% of paediatricians recommended oral rehydration salt (ORS) in encounters involving more than 500 patients. More than 40% of primary care physician visits and 42% of paediatricians visits involved the prescription of an antibiotic, 65% of primary care physician visits involved the prescription of an antidiarrheal medication, and 42% of primary care physician visits and 36% of paediatricians visits involved the prescription of an antiamoebic medication. When we analysed all of the visits, we found that general practitioners (GPs) and paediatricians (paediatricians) prescribed ORS in 55 and 53% of visits, antibiotics in 44 and 39%, antidiarrheals in 47 and 32%, and antiamoebics in 29 and 24%. Cotrimoxazole was among the most commonly recommended antimicrobial drug by both primary care physicians and specialists. In general practise, antidiarrheals were prescribed more frequently than in Paediatric practise. Seventy-seven percent of the time, primary care physicians used "mixtures," or home-made medication preparations. Patient visits with paediatricians lasted an average of 8 +/- 3 minutes, while visits with general practitioners lasted an average of 4 +/- 1 minutes. These findings point to an issue with under-prescribing ORS and over-prescribing antibiotics, anti-amoeba drugs and anti-diarrhea drugs. Prescription habits of these populations require careful planning of intervention techniques.
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