Cross-sectional review of prescription practices of triple action creams amongst doctors in South-East Nigeria

Abstract

Background: Topical corticosteroids have had an immense impact in the treatment of skin diseases since their advent and are important in the management of corticosteroid-responsive dermatoses. Triple action creams (TAC) on the other hand are a combination of antibiotics, antifungals and corticosteroids in one cream, in an unspecific bid to target infected dermatoses. The use of TAC has constituted a source of corticosteroid misuse and abuse. This study aims to determine the knowledge, attitude and prescription practices of TACs among doctors in South-Eastern Nigeria.

Methodology: A section of doctors in the five South Eastern states of Nigeria participated in this study. Data was collected using printed or e-copies of pre-tested questionnaires. Information about sociodemographics, steroid classification, the role of TAC, steroid side effects, and duration of prescription of TAC, were sought. Statistical analysis was carried out using the statistical package for social sciences version 20. Good knowledge of TAC was set at >65% and poor knowledge at <65%.

Results: Two hundred and six doctors participated, 59.2% (122) males and 40.8% (84) females. Respondents were distributed as follows:  Enugu 28.2% (58), Abia 25.2% (52) Imo 18.4 % (38), Ebonyi 17.5% (36), and Anambra 10.7 % (22).  One hundred and seventy-eight (86.4%) work in a tertiary facility while 13.6 %( 28) work in primary/secondary facilities. About forty-eight per cent (99) had good knowledge while 51.9 %( 107) had poor knowledge. Twenty-five per cent (52) knew that TAC is not useful in managing skin disorders while 66% (136) prescribed TAC as first-line therapy.

Conclusion: This study has helped uncover the magnitude of poor knowledge and prescription practice of TAC amongst doctors. To curb topical steroid misuse in a given population, doctors should be re-trained.