Physicians' prescribing practice for treatment of acute diarrhoea in young children in Jakarta.

Abstract

Prescribing practices of physicians who treat acute childhood diarrhoea in Penjaringan, an urban district of Jakarta, were investigated utilising observations of clinical practice and interviews with physicians. One hundred thirty-four physicians registered in Penjaringan district in their practices; 122 physicians (91%) participated in the survey and 73 (55%) were included in the observational study. Reported and observed practices are compared. Results show that 78% of the physicians reported that they frequently prescribe Oralit, a solution for oral rehydration therapy (ORT). However, observation of clinical cases indicates that Oralit was prescribed less frequently than reported. Although most physicians believed viral infections were a common cause of diarrhoea, antibiotics were prescribed for children in 94 percent of observed cases. Antispasmodic drugs were also commonly prescribed. Factors associated with physicians' prescribing behaviour and practices regarding diarrhoeal diseases include type of practice, concepts about aetiology, perceptions about ORT and parental expectations. The observed discrepancy between knowledge and practice suggests the need for new ways to encourage physicians to prescribe Oralit and to limit use of antibiotics and antidiarrhoeals of doubtful efficacy.