الفهرس 
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Abstract
For many years, proper application of antibiotics (ABs) has been difficult to regulate and to control. Several studies have shown that administration of antibiotics was inappropriate in 22% to 65% of patients that received treatment.
This study aimed to evaluate prescription practices of antibiotics in respiratory tract infections among patients
The current study was prospective in design. It was conducted in Imbaba chest hospital and included 30 physicians for evaluation of their antibiotic prescription pattern and 95 patients evaluating their antibiotic prescription pattern for respiratory tract infection during their admission to the ward and RICU
Near half of physicians (46.67%) had their scientific data about antibiotics from text books, the rest of them use internet and pharmaceutical company reports (20% for each) to enhance their knowledge about antibiotics and the prescription of antibiotic for managing RTI depend mainly on empirical base (100%) of physicians.
The commonest factors that interfere with antibiotic selection were severity of infection and its site (86.67% and 73.33% respectively), followed by patient’s age and co-morbidities (60% and 46.67% respectively) then efficacy of antibiotics and its side effects (46.67% and 26.67%) respectively.
The most frequent antibiotics prescribed empirically by physicians were cephalosporin and quinolone (53.33 and 26.67%) respectively.
The prescription of antibiotics based mainly on clinical and radiological evidence (60%) followed by clinical and laboratory base (20%). The most frequent symptoms that affect AB prescribtion were fever, purulent sputum (53% and 33%) respectively
The physicians mainly evaluated the efficacy of antibiotics depending on improvement of general condition (80%) then by TLC recovery to normal values (13.33%).
The mean age of patients with RTI who included in the study was 50 years old with a range from 15 to 85 years. Most of them were males (55.79%) and non-smokers (62.11%)
The majority of cases with RTI were admitted to ward 82%. 65.26% of patients had co-morbidities, the most frequent were HTN and DM (24.21 and 20%) respectively.
Regarding the patient diagnosis, 51.5% of patients were diagnosed as AE, COPD, 20% CAP, 8.4% HAP, 8.4 bronchiectasis, 10.5 % AE, IPF.
Fever and cough were the most prevalent symptoms present in patients with RTI (76.84 and 74.74%) respectively associated with dyspnea (62.11%).
The most common combination therapy at admission were quinolones-cephalosporin (38.95%) and Macrolides-cephalosporin (32.63%), while macrolides alone was less common (3.16%). About 80% of patients had antibiotics through iv route, 5.26% of cases switched to oral medication early and 6.32% of cases their AB group was changed.
The ABs prescribed on admission to patients included in the study showed a statistically significant difference regarding site of care, as about 53% of patients received carbapenems on admission to RICU while none of patients received the same group of AB on admission to ward. Also, about 48% of patients received Quinolones on admission to ward while 12% of patients received Quinolones on admission to RICU.
The duration of AB used since admission ranged between 3 and 23 days with a mean about 7 days.
from the present study it is concluded that:
1. The most common source of physicians’ information about antibiotics was text books followed by internet then lectures and medical journals.
2. The prescription of antibiotics for managing RTIs depends mainly on empirical base as regarding mostly the physicians own experience.
3. The most frequent co-morbidity that affect antibiotics prescription was HTN followed by DM and chronic lung diseases then cardiac and liver diseases.
4. COPD, AE was the most common cause of RTIs among patients included in the study followed by CAP, HAP and bronchiectasis then IPF, AE.
5. The most common combination therapy for RTIs at admission were quinolones-cephalosporin and Macrolides-cephalosporins.
6. The duration of AB used in RTIs since admission ranged between 3 and 23 days with mean about 7 days.