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Introduction: This study has the aim to identify the prevalence and analyze the appearance of antibiotic use which is not corresponding to Upper Respiratory tract Infection (URI) clinical guideline. Materials and Methods: The data from 880 patients with URI Diagnosis and treated in 22 Sub-district Health Promoting Hospital in Buayai Contracted Unit of Primary care was simple random sampling retrospectively collected from electronic health record named HosXP between 1st October 2013 to 30th September 2014 and analyzed the appearance of antibiotic medical record for URI then compared data with FDA’s treatment guideline. Results: According to 880 data of patients, 29.77% (262/880) of antibiotic medical record data was not corresponding to the treatment guideline. This was including (1) Medication use without indication 81.30% (213/262); 185 patients have lower body temperature than 39º, 24 patients have normal physical examination status and 101 patients have symptom no need to take any antibiotic. (2) Untreated indication 4.58% (12/262) and (3) inappropriate medication regimen 14.12% (37/262); 10 patients have Inappropriate medication indication and 27 patients have Inappropriate medication dosage. Conclusions: For the safety of antibiotic use, medication treatment should correspond to URI Clinical guideline for maximum effectiveness. In this study, the most of antibiotic use appearance which is not corresponding to URI clinical guideline is medication use without indication. This affects antibiotic resistance and too much budget of treatment lost problems. Thus the researcher recommends for further study of Medication use without indication factors finding the way to improve more standard quality of drug prescription
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