Cefalexin prescribing appropriateness in general practice: an evaluation study
Ibrahim S. Al-Busaidi
1 * , Sarmad Qamar 1 , Yao-Min Lin 1 , Dee Mangin 1 , Ben Hudson 1
1
Abstract
Antibiotic misuse and overuse, among other factors, are the main drivers of increased antimicrobial resistance. Although cefalexin is generally recommended as a second-line agent, recent trends in Aotearoa New Zealand (NZ) indicate increased community use, highlighting the need for closer scrutiny.
This preliminary study aimed to assess the appropriateness and guideline compliance of cefalexin prescribing.
We conducted a cross-sectional study reviewing all cefalexin prescriptions issued at a single urban medical centre in Ōtautahi Christchurch, NZ, during July–August 2023. Retrieved prescriptions were assessed for guideline compliance and clinical appropriateness using a modified audit survey based on national and regional guidelines.
We identified 27 cefalexin prescriptions provided to 25 patients (16 female, 20 NZ European; median age 48.9 years, IQR 49.7). Soft tissue (n = 11, 42.3%) and genito-urinary infections (n = 10, 38.5%) were the most common indications. Of the assessable prescriptions (n = 26), 14 (53.8%) were guideline compliant, and 15 (57.7%) were clinically appropriate. Indications were documented in 22 cases (84.6%) – 6 on the prescription and 19 in the clinical record.
This exploratory study identifies areas for targeted antimicrobial stewardship interventions in general practice to promote improved prescribing practices. A larger multicentre study is planned to further investigate prescribing patterns and appropriateness.
Keywords: antibiotic stewardship, antimicrobial resistance, cefalexin, community prescribing, guideline compliance, general practitioners, primary care, New Zealand.
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