Abstract
The study explored the patterns of antibiotic utilization, the antibiotic control and surveillance systems,
and measures in promoting rational use of antibiotics among public and private hospitals, health
promoting hospitals, clinics, and drug stores. A cross-sectional survey using self-administered questionnaires
was conducted in 9 purposive sampling provinces in Thailand during April-May 2012. The preliminary
results were analyzed from 484 returned questionnaires (30% response rate) from 10 large public
hospitals, 11 private hospitals, 53 district hospitals, 184 sub-district health promoting hospitals, 69 private
clinics and 157 drug stores. The findings revealed that all of 47 items of antibiotics listed in the questionnaire
were available in large public hospitals whereas private clinics and drug stores had 35 and 36 items
of antibiotics, respectively. Ceftriaxone, a third generation cephalosporin, and fluoroquinolones were available
in all levels of healthcare facilities as well as drug stores. A measure regulating prescription only sales
of all antibiotics created a wide range of disagreements among respondents from different health facilities
i.e. a vast majority of private hospitals (82%) but only 8% of drug stores agreed with such a measure.
However, the regulatory measure emphasizing prescription only sales of some antibiotics appeared to be
acceptable for all levels of health facilities and drug stores. The rate of antibiotic prescription for upper
respiratory infection and acute diarrhea in district health promoting hospitals (35% - 40%) was lower than
those in the private clinics and drug stores (43% - 56%). Most large public hospitals (90%) applied drug
utilization evaluation whereas almost all district hospitals (98%) implemented the antibiotics smart use
concept in promoting rational use of antibiotics. The study results demonstrated that operating systems to
strengthen antibiotic regulation and to promote rational use of antibiotics are strongly needed in all levels
of health facilities and drug stores.
