An Assessment of Antibiotics Prescribed at the Secondary Health-care Level in the Kyrgyz Republic

This study was undertaken to evaluate the pattern of antibiotic prescriptions in a secondary health care setting in Kyrgyzstan. A retrospective analysis was performed of antibiotic prescriptions in 251 inpatient records of patients admitted to the Sokuluk Territorial Hospital. A total of 19 different antibiotics were prescribed. Penicillin G (24.9%), gentamicin (16.1%), metronidazole (15.6%) and cefazolin (14.5%) were those most frequently prescribed. The major indications for antibiotics were diseases of the respiratory system (28.0%), injury, poisoning and certain other consequences from external causes (25.5%), and diseases of the digestive system (14.3%). Almost three-quarters of the antibiotics were used parenterally, 252 of which (58.9%) were administered intramuscularly and 70 (16.4%) intravenously. Forty-five percent of the patients received two antibiotics, and 12.0% received three antibiotics during their stay at the hospital. Antibiotic therapy proved inappropriate for 184 patients (73.3%). The most common reason given for inappropriateness was the unjustified (not indicated) use of antibiotics in 143 (48.6%) cases. There was a significantly higher inappropriate choice of antibiotics in gynecology (OR = 2.70, 95% CI = 1.02-7.69) when compared with that in other wards. Although antibiotics were prescribed in all cases post-operatively, none of those patients were given pre-operative prophylactic antibiotics when indicated. We concluded that antibiotic prescriptions were seriously inappropriate in the Kyrgyz Republic with prescribing patterns failing to strictly adhere to the national guidelines. Adoption of an international standard and locally conformable guidelines of antibiotic use can help correct such problems.