DRUG PRESCRIBING PRACTICES OF GENERAL-PRACTITIONERS AND PEDIATRICIANSFOR CHILDHOOD DIARRHEA IN KARACHI, PAKISTAN

Observations were made of 996 encounters between children with diarrho ea and practitioners (28 paediatricians, 62 general practitioners) in Karachi, Pakistan. Oral rehydration salt (ORS) was prescribed in more than 50% of encounters by 53% of general practitioners (GPs) and 61% o f paediatricians. Sixty-six percent of GPs and 50% of paediatricians p rescribed antibacterials, 60% of GPs and 28% of paediatricians prescri bed antidiarrhoeals and 39% of GPs and 32% of paediatricians prescribe d antiamoebics in more than 30% of their encounters. Looking at all th e encounters, we observed that ORS was prescribed in 52 and 51%, antib acterials in 41 and 36%, antidiarrhoeals in 48 and 29%, and antiamoebi cs in 26 and 22% of encounters by GPs and paediatricians, respectively . Cotrimoxazole was the most frequently prescribed antibacterial by bo th types of practitioners. Antidiarrhoeals were prescribed more often by GPs than by paediatricians. In 77% of their encounters, GPs dispens ed drug formulations known as 'mixtures' made in their own dispensing corners. The mean duration of encounters between patients and GPs was 3 +/- 2 minutes and between patients and paediatricians was 9 +/- 4 mi nutes. These results indicate inadequate prescription of ORS and exces sive prescription of antibacterials, antidiarrhoeals and antiamoebics. Intervention strategies need to be planned to improve the prescribing practices of both groups.