scholarly journals Study of drug utilization trends in respiratory tract infections in a tertiary care teaching hospital: a retrospective study

Author(s):  
Avula Naveen ◽  
M. R. Sravani

Background: Drug utilization studies play crucial role in the health sector and ultimately it provides insight into the efficiency of drug use and results of such research can be used to help to set priorities for the rational use of medicines and allocation of health care budgets. Respiratory tract infections (RTIs) contributing to significant mortality and morbidity of populations especially in developing countries like India. Polypharmacy and irrational prescription are significant negative fallouts in treatment of RTIs. Keeping in view of this, our study was undertaken to analyze the drug utilization pattern of RTIs.Methods: The study was conducted at Gandhi Hospital, after obtaining permission from the Institutional Ethics Committee. We have collected data of 600 case records of the patients diagnosed with respiratory tract infection and evaluated for prescribing patterns in consonance with WHO indicators.Results: Out of the total case records 348 (58%) were of male patients and 252 (42%) of female patients. Age wise distribution was done; 79 (13.16%) 0-15 years, 46 (7.67%) 16-30 years, 123 (20.50%) 31-45 years, 194 (32.33%) 46-60 years and 158 (26.33%) patients belongs to >60 years of age group respectively. A total of 4682 drugs were prescribed, 2468 (52.71%) antibiotics, 768 (16.4%) bronchodilators, 581 (12.4%) corticosteroids, 323 (6.89%) antacids, 542 (11.57%) in miscellaneous category respectively. With regard to formulations 2463 (52.60%) oral, 1463 (31.24%) injectable and 756 (16.14%) inhalational drugs were prescribed. Numbers of Fixed dose combinations were 712 (15.20%). 7.8 drugs were prescribed per prescription. 2493 (53.24%) drugs were prescribed from National Essential Medicine List. 4168 (89.02%) drugs were prescribed by their brand names.Conclusions: Prescription of drugs with branded names, Irrational prescribing, poly pharmacy were observed in our study. So there is an urgent need for creating awareness among the health care professionals regarding rational prescription by using data from from drug utilization studies. 

Author(s):  
Mirza A. Beg ◽  
Shakti B. Dutta ◽  
Shalu Bawa ◽  
Amanjot Kaur ◽  
Subhash Vishal ◽  
...  

Background: Respiratory tract infections are a major cause of morbidity and mortality in developing countries. Polypharmacy and irrational prescribing in respiratory diseases are common practice worldwide. Keeping in consideration this scenario, present study was undertaken to analyze the drug utilization pattern of respiratory tract infections.Methods: This drug utilization study was conducted by Pharmacology department at SGRRIM & HS to analyze drug utilization pattern of respiratory infections. A total of 585 prescriptions were collected from hospital and randomly evaluated for prescribing pattern using WHO drug indicators.Results: A total of 585 prescriptions were analyzed. Male:Female ratio was 1:0.77. Age wise distribution was done; 81(13.84%) 0-15 years, 54(9.23%) 16-30 years, 198(33.84%) 31-45 years, 75(12.82%) 46-60 years and 177(30.25%) patients belongs to >60 years of age group respectively. A total of 4869 drugs were prescribed, 2754(56.56%) antibiotics, 675(13.8%) bronchodilators, 630(12.93%) corticosteroids, 303(6.22%) antacids, 507(10.41%) in miscellaneous category respectively. 2562(52.61%) oral, 1491(30.62%) injectable and 816(16.75%) inhalational drugs were prescribed. Numbers of Fixed dose combinations were 645(13.24%). 8.32 drugs were prescribed per prescription. 2409(49.47%) drugs were prescribed from national essential medicine list 2015. 4320(88.72%) drugs were prescribed by their brand names.Conclusions: Irrational prescribing and polypharmacy was observed. The drug utilization studies are important tool to sensitize and increases awareness among physicians, which ultimately improves rational prescribing and patient care.


2018 ◽  
Vol 11 (4) ◽  
pp. 1903-1911 ◽  
Author(s):  
Sujata Jadhav ◽  
Chitra Khanwelkar

Acute respiratory tract infections (ARTI) are very common in all age groups. Childhood respiratory tract infections are responsible for considerable morbidity and mortality. It is significant health problem in India also. The World Health Organization (WHO) estimates that 2 million children under five years of age die due to pneumonia. Majority of ARTIs have viral etiology. Rhinoviruses, respiratory syncytial viruses, parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses are main causative agents. Among bacteria, group A streptococci, Corynebacterium diphtheriae, N. meningitides, H. influenzae, pneumococcus and Staphylococcus aureus are responsible for ARTIs. Drug utilization studies help to understand the pattern of prescription in that particular area for specific conditions.We included children from one to five years of age, diagnosed as ARTI and evaluated 298 prescriptions given to these children. Analysis of these prescriptions was done as well as they are compared with WHO prescription indicators. Cough (96%), fever (93%) and rhinitis (82.5%) were common symptoms observed, but sore throat, earache and breathlessness were also present in these children. Average number of drugs prescribed was 4.1/patient. Following drugs were prescribed, Antipyretics 98.3%, antimicrobials 91.3%, antihistaminics and cough syrups in 75.2%, Leukotriene antagonist in 25.1% patients, Vitamin B complex 11% and glucocorticoids 4.6%. All drugs were prescribed by brand names and not by generic name. 97.3% prescribed drugs were from national list of essential medicine. We found overuse of antimicrobials in our study. Educational programs are needed in order to bring rational use of antimicrobials. At the same time awareness in parents also should be done regarding antimicrobial use.


2021 ◽  
pp. 14-19
Author(s):  
M. B. M. R. D. T. Marapana ◽  
K. S. Dilrukshi ◽  
M. G. S. D Bandara ◽  
M. M. Weerasekara ◽  
J Kottahachchi

Health care associated infections are considered as an indicator of quality and safety of health care institutions. The study aimed to determine the proportion of health care associated urinary tract infections, respiratory tract infections, surgical site infections, and to evaluate the association of medical devices and duration of hospitalization which predispose to health care associated infections. Four hundred and twenty three patients who stayed more than 48 hours or readmitted to surgical, medical, pediatric and gynecology wards in a tertiary care hospital in Sri Lanka during the study period were included in the study. Data extraction sheets were used and were filled with information obtained from bed head tickets and laboratory reports. A total of 79 (18.7%) patients had been diagnosed to have health care associated infection. The predominant type was respiratory tract infections 24 (30.4%) followed by urinary tract infections 21(26.6%), surgical site infections 17 (21.5%), and other infections 17 (21.5%). The highest proportion of urinary tract infections were seen in surgical wards (38.1%) whereas the highest proportion of respiratory tract infections were seen in medical wards (45.8%). Patients aged more than 60 were found to be affected most (27/94). Health care associated infections were significantly associated with usage of medical devices (p<0.05) and length of stay in hospital (p<0.05). The study concludes that these infections account for a noteworthy percentage in hospitalized patients and the predominant type was respiratory tract infections in this tertiary care hospital in Sri Lanka and elders were the mostly affected category compared to children and adults age groups.


2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.


2021 ◽  
Vol 1 (S1) ◽  
pp. s31-s32
Author(s):  
Amanda Gusovsky ◽  
David Burgess ◽  
Donna Burgess ◽  
Emily Slade ◽  
Chris Delcher ◽  
...  

Background: A team of infectious diseases physicians, infectious diseases pharmacists, clinical laboratorians, and researchers collaborated to assess the management of lower respiratory tract infections (LRTIs). In 1 sample from our institution, 96.1% of pneumonia cases were prescribed antibiotics, compared to 85.0% in a comparison group. A collaborative effort led to the development of a protocol for procalcitonin (PCT)-guided antibiotic prescribing that was approved by several hospital committees, including the Antimicrobial Stewardship Committee and the Healthcare Pharmacy & Therapeutics Committee in December 2020. The aim of this analysis was to develop baseline information on PCT ordering and antibiotic prescribing patterns in LRTIs. Methods: We evaluated all adult inpatients (March–September 2019 and 2020) with a primary diagnosis of LRTI who received at least 1 antibiotic. Two cohorts were established to observe any potential differences in the 2 most recent years prior to adoption of the PCT protocol. Data (eg, demographics, specific diagnosis, length of stay, antimicrobial therapy and duration, PCT labs, etc) were obtained from the UK Center for Clinical and Translational Science, and the study was approved by the local IRB. The primary outcome of interest was antibiotic duration; secondary outcomes of interest were PCT orders, discharge antibiotic prescription, and inpatient length of stay. Results: In total, 432 patients (277 in 2019 and 155 in 2020) were included in this analysis. The average patient age was 61.2 years (SD, ±13.7); 47.7% were female; and 86.1% were white. Most patients were primarily diagnosed with pneumonia (58.8%), followed by COPD with complication (40.5%). In-hospital mortality was 3.5%. The minority of patients had any orders for PCT (29.2%); among them, most had only 1 PCT level measured (84.1%). The median length of hospital stay was 4 days (IQR, 2–6), and the median duration of antibiotic therapy was 4 days (IQR, 3–6). Conclusions: The utilization of PCT in LRTIs occurs in the minority of patient cases at our institution and mostly as a single measurement. The development and implementation of a PCT-guided therapy could help optimize antibiotic usage in patients with LRTIs.Funding: NoDisclosures: None


Author(s):  
Divya Bade ◽  
Shivashankaramurthy K. G. ◽  
Kiran L. J. ◽  
Raghuprasada M. S. ◽  
Harishkumar V. S. ◽  
...  

Background: Upper respiratory tract infections are one of the leading causes of hospital visits worldwide. Judicious use of antibiotics is challenging for upper respiratory tract infections (URTIs) in developing countries like India. This leads to inappropriate use of antibiotics causing many dreaded conditions like antibacterial resistance among other things. Hence rational use of drugs, mainly antibacterial, is a priority to reduce the burden of treatment failure. The objective of this study is to study the prescribing patterns and rationality of drugs prescribed in the management of URTIs.Methods: This was a cross-sectional study. Data was collected from records of 300 outpatients clinically diagnosed as URTIs from SSIMS and RC Hospital, Davangere between January 2015 and June 2016. The prescribing patterns, approval status and listing of drugs in World Health Organization (WHO) essential medicines list/ National List of Essential Medicines (NLEM) were analysed. The data was presented as percentages, mean and standard deviations.Results: A total of 300 cases were studied. Among these, acute pharyngitis (29%) and acute sinusitis (26%) are the most common infections. Of the 300 cases studied, 283 (94.3%) were prescribed antimicrobials. Of the total 740 medications prescribed, 393 (53.1%) were fixed-dose combinations (FDCs). A total of 724 medications (97.8%) were approved by Drugs Controller General of India and 248 (33.5%) by Food and Drug Administration. Only 5.8% of the prescribed drugs have been listed in WHO’s and NLEM. The most common class of antibacterials prescribed was Beta-lactams.Conclusions: Oral formulations were preferred over parenteral formulations and FDCs were preferred over single drug formulations. Beta-lactams comprised the major class of antibacterial prescribed.


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