Drug use evaluation of oral antibiotics prescribed in the ambulatory care settings in the Canadian armed forces.

OBJECTIVES: The primary objective was to evaluate the level of compliance of military prescribers (physician assistants, general practitioners and specialists) with treatment guidelines for commonly encountered community-based infections. The secondary objective was to identify infections encountered in the Canadian Forces ambulatory care services and to determine which ones were most frequently associated with noncompliance or partial compliance for the purpose of developing a training program for prescribers. METHODS: Retrospective chart review was performed using prescriptions written within a predetermined time frame. Appropriateness of prescribing was evaluated by comparing the drug prescribed for the indication with two sets of guidelines. RESULTS: A total of 704 charts were reviewed, of which 458 charts met inclusion criteria. From these, 477 prescriptions for anti-infectives were analyzed. Seventy-three per cent of the prescriptions analyzed were for the treatment of infections related to the respiratory system. Compliance rates were similar between physician assistants and general practitioners (ie, 86.2% and 85.3%, respectively). There were not enough data to assess accurately the compliance rate of specialists. The indications most commonly associated with noncompliance and/or partial compliance were bronchitis, community-acquired pneumonia, cellulitis, otitis media, pharyngitis, sinusitis and urinary tract infections. CONCLUSION: The majority of prescriptions met the criteria for compliance and the compliance rates among physician-assistants and general practitioners were similar. However, certain indications were associated with a significant level of partial or noncompliance. A training program should be developed to improve adherence to prescribing guidelines.