Impact of national protocol on management of acute respiratory infections in children.

OBJECTIVE: To measure the impact of implementation of the national protocol on the prescribing patterns for acute respiratory infections among children attending a large primary health care center in Abha City. METHODS: This study was carried out during December of 1997 and February of 1998 in Abha City, Asir Region, Kingdom of Saudi Arabia. One quarter of the prescriptions which were issued in those 2 months were selected randomly and assessed for age, sex, diagnosis and the prescribed drugs before and after intensive training of the primary health care physicians on the implementation of the national protocol for acute respiratory infections. RESULTS: One hundred and forty five and 123 prescriptions were selected and assessed pre and post the implementation of this protocol. Our findings showed a decrease in the prescription of antibiotics from 53% to 33%, anti-cough drugs from 43.5% to 6%, and anti-histaminics from 20% to 10%. CONCLUSION: Training on the national protocol and its implementation will decrease the rate of prescribing and misuse of unnecessary drugs such as antibiotics, anti-cough and anti-histamines.

Audit of management of respiratory infections among children.

OBJECTIVE: To study the pattern of drugs prescribing for acute respiratory infections among young children under 5 years and to establish the first step in auditing acute respiratory infections management in two large Primary Health Care Centers in Abha, Asir region. METHODS: Three hundred and thirteen prescriptions of children less than 5 years old were selected randomly and evaluated for: age, sex, nationality, and drugs prescribed in two large Primary Health Care Centers in Abha city, Asir region, Saudi Arabia. The medical records of children who received antibiotics were further evaluated for: process of recording symptoms and signs and appropriateness with diagnosis. Structures of acute respiratory infections care in both Primary Health Care Centers were evaluated in both centers using checklist and scoring system. RESULTS: Common cold was the most common diagnosis encountered. Antibiotics were the most common prescribed drugs in both Primary Health Care Centers. Less than one third of files revealed appropriate recording of history and physical examination. CONCLUSION: There were inadequate structures in both Primary Health Care Centers which negatively affected the process of acute respiratory infections care in both centers. Urgent providing of those structures and establish continuing medical education for the Primary Health Care Center team and health education of the community about acute respiratory infections are two important priorities at both Primary Health Care Centers.