Antibiotic prescription patterns among HIV-infected patients with respiratory infections in Uganda

\u22Objective\u22 : To describe antibiotic prescription patterns among HIV infected patients aged 2 months and above, who presented with respiratory symptoms at an HIV specialty clinic in Uganda. \u22Design\u22: A cross-sectional descriptive study of electronic medical records. \u22 Methods\u22: We abstracted electronic medical records data collected on patients who attended the clinic between January 2010 and December 2012. Frequency and chi-square analyses were conducted to assess the frequency and type of prescription errors reported and to identify factors related to receipt of an inappropriate antibiotic prescription. \u22Results\u22: A sample of records for 351 patients with 637 clinic visits from January 2010 and December 2012 was obtained and analyzed. Median age was 35.2 months (IQR: 14.5-92.3). Inappropriate prescriptions were prescribed for 161 (45.9%), 120 (48.4%) and 93 (50.0%) patients on their first, second and third visits, respectively. Shorter prescription duration was the most prevalent error (37.4%). Significant differences in the frequency of inappropriate antibiotic prescriptions were seen by patient age, (X2=7.9; p= 0.017), use of additional diagnostic tests, (X2=7.9; p = 0.047), admission status (X 2 = 6.5; p= 0.011), ARV status (X2 = 8.1; P= 0.017) and type of medical provider (X2 = 32.5; p= 0.000, X 2 = 6.9; p= 0.032, X2 = 7.3; p= 0.026). \u22Conclusions \u22: Inappropriate antibiotic prescription practices among HIV patients in Uganda were high, particularly among the older children and adults. Short prescription duration was the most prevalent error. Continuous medical education training is a potential intervention to improve prescription skills for clinicians in HIV clinics.