Prescription Pattern of Antibiotics for Treatment of Acute Illnesses in India: Evidence from IHDS-2

Abstract

This paper examines the extent of use and socio-economic determinants of antibiotics for treatment of acute illnesses in India. The study uses IHDS-2 (2011-12), a nationally representative sample survey, for analysis. Four acute illnesses are included in the study: fever, cough, cough with short breath and diarrhoea. Bivariate analysis and logistic regression are used to examine the relationship between acute illness and antibiotic use. The overall prevalence rate of acute illness was around 17.4 per cent and was the highest for fever (15.6%) followed by cough (11.7%). Around one-fourth of the patients with acute illness were prescribed antibiotics. The prescription of antibiotic was the highest for cough with short breathe (32.8%), followed by diarrhoea (~27%). The odds of antibiotic prescription were 14 per cent (OR=1.14; 95% CI: 1.04-1.26) and 35 per cent (OR=1.35; 95% CI: 1.11-1.63) higher among individuals aged 5-14 years and 70 or more years compared with children aged less than 5 years. Individuals from the richest quintile were 56 per cent (OR=1.56; 95% CI: 1.42-1.72) more likely to be prescribed antibiotics compared with the poorest quintile individuals. The odds of antibiotic prescription for acute illnesses were 39 per cent lower among private doctors/nurses (OR=0.61; 95% CI: 0.58-0.65) as compared with government doctors/nurses. A higher prescription rate for acute illness, especially diarrhoea, majority of which doesn’t require antibiotic therapy indicates that there is a need of awareness programmes and routine surveillance system for antibiotic use along with existing surveillance of antibiotic resistance.