scholarly journals A prospective study on antibiotic prescribing pattern among in-patients of medicine department of a tertiary care hospital

Author(s):  
Anulakshmi S. ◽  
Annapurna Yadavalli

Background: Irrational prescription is a major contributor to the antimicrobial resistance. Tertiary care centres in a state are the centres of excellence where policies are framed. So, they have an important role in promoting rational antibiotic prescription.Methods: The study was conducted on in-patients of medicine ward in government medical college, Calicut, for a period of 2 months (January to February 2018), The data was collected from IP case records of patients. The parameters checked includes appropriateness of the antibiotic as, to whether it is according to our hospital antibiotic policy, whether de-escalation and change to oral drug was done, whether it is prescribed by generic name, is it given as fixed drug combination (FDC), is it from national list of essential medicine.Results: Among the 135-prescription analyzed, total 225 antibiotics were used. Cephalosporins (32%) were the most commonly used. Of this only 40% was given by generic prescription. 27% was FDCs. 55% was from national list of essential medicines and 69% of them were ‘WATCH’ drug according to WHO Antibiotic Policy. Regarding appropriateness of prescriptions around 56% included right drug, 93% had right dose and frequency, and 70% had right duration and 100% were given through right route.Conclusions: Strict adherence to hospital antibiotic policy and plan for effective teaching programs regarding antibiotic resistance and importance of rational prescription of antibiotics can improve the quality of antibiotic prescription and minimize antibiotic resistance.

Author(s):  
Roshi . ◽  
Vishal R. Tandon ◽  
Brij Mohan Gupta ◽  
Sanjeev Gupta

Background: Prescribing drugs for any disease is not complete until it is rationally done. Irrational prescriptions often lead to treatment failure, toxicity or drug interactions which may prove detrimental to the patient. Antibiotics are very much prescribed in day to day practice but their rational use prevents treatment failure, resistance.Methods: A cross sectional study was conducted in a tertiary care hospital to see the antibiotic prescribing pattern. Prescriptions were screened one time from different OPDs with prior permission from the doctor attending the respective OPD.Results: A total of 200 prescriptions were assessed out of which 121 had monotherapies prescribed, 79 had FDCs. Antibiotics were the most commonly prescribed drugs. Prescriptions having drug combinations were assessed and pantoprazole domperidone was the most commonly prescribed (32.91%).Conclusions: Drugs should be prescribed rationally for proper therapeutic benefit. It encourages the patient to properly use the medicine and properly comply to it.


Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.


Author(s):  
Pritpal Singh Ahluwalia ◽  
Mirza Shiraz Baig ◽  
Amarnath Awargaonkar ◽  
Varsha Nandedkar

Background: Drug utilisation studies in present clinical practice have played significant role to promote rational drug use in the current health care system. The aim of present study was to analyse the prescribing pattern of drugs for various ocular conditions in Ophthalmology Department of Government Medical College and Hospital, Aurangabad, Maharashtra, India.Methods: Study was prospective, observational open label and descriptive clinical study which included 100 patients in OPD and IPD during November 2018 to February 2019 fulfilling inclusion criteria.Results: Out of the 100 study subjects, 56% were males and 46% were females, with the maximum number of patients falling in the age group 61-80 years. 38.26% patients received antibiotics as most prescribed drug while 69 % patients received analgesics and 47% anti-inflammatory. Among the antibiotics prescribed, fluoroquinolones were the most prescribed antimicrobial class. WHO prescribing indicators as analysed from the data collected were: average number of drugs per prescriptions was 3.79. Percentage of medicines prescribed by branded name- 33.79% and generic were 66.21%. 54% of the total drugs prescribed were from the National List of Essential Medicines 2017.Conclusions: Ocular ailments and conditions are frequently associated with high levels of utilization of drugs for their treatment. Thus, analysis of utilization of these drugs becomes very essential. In the present study, the drugs prescribed at our tertiary care hospital were found rational.


Author(s):  
V. V. Rajesham ◽  
Ch. Swethasri ◽  
E. Mamatha ◽  
Keerti Tiwari ◽  
P. Pooja Raj

Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history,drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.


Author(s):  
R. P. Priyadharsini ◽  
R. Kesavan

Background: The usage of antibiotics among paediatric age group in India is on the higher side, that more than 60% of children in the age group 0 to 4 years received antibiotics. The higher use of antibiotics results in antibiotic resistance, increased health care costs, adverse drug reaction and may complicate the treatment of infections in future. There is a continuous need to monitor the prescription of antibiotics at all health care levels to prevent antibiotic resistance.Methods: A prospective and descriptive study was conducted in one of the pharmacies which dispenses the paediatric prescriptions in a tertiary hospital. The prescriptions used to treat infection were collected and analysed. A total of 500 prescriptions were collected and analysed.Results: The prescriptions were analysed for the WHO prescribing indicators. The average number of drugs per prescription is 1.84 with 21% of the prescriptions containing antibiotics. The most commonly prescribed antibiotics were penicillin like amoxycillin, phenoxymethyl penicillin followed by cotrimoxazole and cephalosporin group of antibiotics. The antibiotics prescribed belonged to the access group of antibiotics. The percentage of the prescriptions with drugs form essential drugs list and prescribed with generic name is 65.8% and 67% respectively. There were no injections prescribed.Conclusions: The antibiotic prescribing pattern and the average drugs per prescription falls with the WHO range indicating reduced use of antibiotics and absence of polypharmacy. However, the prescription of generic drugs and the drugs from the essential drug list is less.


Author(s):  
Jyothsnya Srinivasa ◽  
Vijaya Rajendran ◽  
Pratibha Nadig ◽  
Shubhatara Swamy

Background: Antibiotics are the most commonly used and misused of all drugs. Patterns of antibiotic resistance widely follows local patterns of antibiotic prescribing and usage. Periodic data collection and analysis of antibiotic prescriptions at regional level are essential to understand and combat antibiotic resistance. Objective of the study was to study the prescribing pattern of antibiotics in outpatient department of Otorhinolaryngology in a tertiary care teaching hospital. Methods: A prospective observational study of prescribing pattern of antibiotics was conducted in the department of Otorhinolaryngology. Data of antibiotic utilization in outpatient department was collected through duplicate copies of the prescriptions. The data obtained was analyzed and the conclusions were drawn using descriptive analysis.Results: A total of 606 prescriptions were collected and analyzed during the study. Average number of antibiotics prescribed per prescription was 1.24 most of the antibiotics were prescribed for a duration of 1 to 5 days. Commonly prescribed antibiotic class was penicillin (48.1%) followed by quinolone (18.3%). Most of the antibiotics were prescribed by their brand names (98.8%).Conclusions: The present study highlights the wide use of extended spectrum antibiotics, along with brand names for prescribing. Interventions for prescribing of generic drugs from the essential drug list needs to be encouraged among physicians.


Author(s):  
Shruthi Rammohan ◽  
Basavaraj Bhandare ◽  
Adarsh E. ◽  
Satyanarayana V.

Background: Dengue fever is a mosquito borne viral infection which has become a global health hazard, especially in tropical and subtropical areas. Children have higher risk of developing severe forms of dengue fever, however, studies show that paediatric complications/fatalities from dengue fever are potentially avoidable by proper management. Data about drug usage patterns for dengue are particularly lacking, especially in the paediatric age group, therefore this study will help facilitate the rational use of drugs and aid in establishing a more specific management for dengue fever. The objective of the present study was to identify the prescribing pattern of dengue fever in paediatric inpatients admitted to RajaRajeswari Medical College and Hospital and assess according to the WHO core prescribing indicatorsMethods: This prospective observational study took place from March 2017 to September 2017 in the paediatric general wards. Data was collected from case files of NS1 positive patients of both genders between 1-18years. Data was analysed using descriptive statistics and expressed as percentages, means and standard deviations. The prescription pattern was analysed using the prescribing indicators mentioned in the World Health Organization core drug use indicators.Results: Total of 300 drugs were prescribed for 110 prescriptions that were analysed excluding IV fluids and blood products. Mean number of drugs prescribed was 2.7±0.8. Drugs prescribed by a generic name was 7.33%. Patients prescribed an antibiotic was 12.73%. Patients prescribed with an injection was 62.72% Majority of drugs prescribed in this study come from essential medicines list created by regulatory bodies. Intravenous fluids were administered to all patients with majority receiving normal saline (60.9%).Conclusions: Mainstay of treatment of dengue fever for paediatric patients is symptomatic along with focus on fluid management. Majority of drugs prescribed are from essential medicines lists formed by regulatory bodies. With dengue infections being a worldwide health hazard, more studies are needed to facilitate rational use of drugs in this disease.


2014 ◽  
Vol 5 (4) ◽  
pp. 69-72 ◽  
Author(s):  
Ravika Kanish ◽  
Kanchan Gupta ◽  
Shivani Juneja ◽  
HS Bains ◽  
Sandeep Kaushal

Background: Systemic antibiotics account for more than one?third of all prescriptions in children; hence, antibiotic prescriptions in children are a major public health concern. Moreover, data regarding rational antibiotic use in children is very limited. Hence, it is essential that the antibiotic prescribing pattern be evaluated periodically for its rationality of use and cost. The aim of our study is to identify the prescribing pattern and to carry out direct cost analysis of antibiotic use in the patients admitted in pediatrics department of a tertiary care hospital of North India. Methods: The study was conducted for two months (June, July, 2012) in pediatric ward and ICU. The data regarding patient demographics and antibiotic use was collected daily in a structured proforma. A descriptive analysis of the data was done. Results: A total of one hundred and ninety one patients were enrolled, most of them belonging to the age group 2?14 years. Majority of them were male pediatric patients (75.9%) with mean age of 4.6 years. On an average 1.9 AMAs were prescribed per patient. The most common AMAs prescribed were cephalosporins followed by aminoglycosides. The preferred route of administration was injectable (92%). The average direct cost of treatment per patient was estimated to be Rs. 3338. The percentage of drugs prescribed by generic name was 58%. Conclusions: Male pediatric patients have better access to tertiary medical care as compared to female pediatric patients. The average number of anti?microbials prescribed is 1.9 which is not too high. Newer generation of antibiotics are more commonly prescribed leading to increased cost of therapy. This baseline study will help in formulating an antibiotic policy and standard treatment guidelines for appropriate use of antibiotics. DOI: http://dx.doi.org/10.3126/ajms.v5i4.10213 Asian Journal of Medical Sciences 2014 Vol.5(4); 69-72


Sign in / Sign up

Export Citation Format

Share Document