scholarly journals Study on antibiotic use among geriatric patients based on anatomical therapeutic classification or defined daily dose methodology and world health organization-essential medicine list access, watch and reserve concept in tertiary care hospital of South India

2020 ◽  
Vol 9 (7) ◽  
pp. 1106
Author(s):  
Subash Senthilkumar ◽  
Arun Raaj S. A. ◽  
Padmavathi K. ◽  
Dhanapal C. K. ◽  
Periasamy K.
Keyword(s):  
Geriatric Patients ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Antibiotic Use ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Daily Dose ◽  
Tract Infections

Background: Geriatric patients are more vulnerable to infections and need special consideration on antibiotic use. Resistance to antibiotics among infectious bacteria has developed within a short span. There is a direct correlation between the consumption of antibiotics and the development of resistance. And surprisingly very few literatures were available on antibiotic consumption in geriatric population using defined daily dose (DDD) concept which paved the idea to conduct this study.Methods: A prospective observational study was carried out from November 2018 to April 2019. A total of 206 prescriptions of elderly patients were included in the study. The antibiotics were categorized by anatomical therapeutic classification (ATC) and DDD indicator/1000 inhabitants/day (DID) was used to figure out antibiotic consumption.Results: About 25.2% of patients were treated with antibiotics for respiratory tract infections. The patients received antibiotics empirically (53.8%) and without bacteriological investigation (58.73%). The overall consumption of antibiotics was 20.47 DID in which oral antibiotics was (8.5 DID) 42% and parenteral antibiotics (11.8 DID) 58%. Cephalosporins was observed to be the most consumed antibiotics (33.2%), specifically cefotaxime (14.6%) and ceftriaxone (12.6%). Moreover, 54.4% of antibiotics consumed from watch category of World Health Organisation (WHO) essential medicines list (EML) which was completely against WHO standard proportion.Conclusions: Higher consumption of cephalosporins, which falls into watch category was analysed in geriatric patients. These broad-spectrum antibiotics have high potential to develop antimicrobial resistance. A strict antibiotic policy is needed to be framed that enhance rational prescribing practices in geriatrics.

scholarly journals Drug utilization pattern among geriatrics according to anatomical therapeutic chemical and defined daily dose classification in a tertiary care hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 1989
Author(s):  
T. Muneswar Reddy ◽  
Thammi Setty Durga Prasad ◽  
Allikesam Hemalatha ◽  
Vanam Chanukya ◽  
Bandi Lakshmi Sirisha
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Daily Dose

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.

scholarly journals Analysis of Essential Medicines Used for Emergency Care in Pakistan

2020 ◽  
Vol 1 (1) ◽  
pp. 75-77
Author(s):  
Talha Khalid ◽  
Amna Khokhar ◽  
Naseem Jehan ◽  
Umar Sultan ◽  
Arooj Fatima
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Care Needs ◽  
Cross Sectional ◽  
Health Organization

Introduction: According to the World Health Organization (WHO), essential medicines (EM) have the ability to meet the health care needs of maximum individuals. High accessibility to essential medicines (EM) was proposed under the Millennium Development Goal. The access to high quality, suitable, and inexpensive essential medicines is an essential constituent of health care systems. Methodology: This retrospective cross-sectional observational study was performed at Jinnah Hospital Lahore from February 2018 to November 2018, for analysis of essential medicine usage in a public sector tertiary care hospital of Pakistan. The data were collected from records of patients admitted in the emergency department. Results: Drugs prescribed per encounter were estimated to be 3. Most patients got a single antibiotic, and cephalosporin was the most commonly prescribed antibiotic. Conclusion: The concept of essential drugs has gained high acceptance, but the EMs should be prescribed logically, appropriately and should be in line with WHO guidelines.

scholarly journals Drug utilization study in geriatric patients visiting medicine OPD in tertiary care hospital

2021 ◽  
Vol 10 (4) ◽  
pp. 386
Author(s):  
Ujwala P. Gawali ◽  
Salman H. Rizvi ◽  
Prashant S. Mishra
Keyword(s):  
Drug Utilization ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
The Elderly ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Practices ◽  
Drug Utilization Study ◽  
Cross Sectional

Background: Drug utilization study is of utmost importance in the elderly. The consumption of drug amongst elderly segment of society is maximum and many of them use at least three prescribed drugs, concurrently. One of the plausible explanation of usage of large number of medicines is prevalence of multi-morbidities as well as suffer from chronic and degenerative pathology amongst them along with the alteration of pharmacokinetics and pharmacodynamics of many drugs are altered with advanced age. Thus, the aim of this study was to assess current prescribing practices among physicians for geriatric patients in tertiary care hospital.Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Medicine in a tertiary healthcare hospital. As per inclusion criteria, patients visiting Medicine outpatient department (OPD) from 01 October 2018 to 31 December 2018 were enrolled in the study.Results: The average number of drugs per encounter was 4.1. 100% of the drugs were prescribed by their generic name and those prescribed from World Health Organization (WHO) list of essential medicines were 70.2%. Analysis of polypharmacy showed maximum 11 and minimum 1 drug was prescribed. Overall analysis of the drugs showed, the most common route of administration was orally. Drugs acting on cardiovascular system (CVS), gastrointestinal system (GI) system, analgesics and anti-inflammatory drugs and vitamins and mineral supplements constitute the major bulk of drug prescribed.Conclusions: In our study, though polypharmacy was found but it was necessary unavoidable, but was within the WHO standards of 1.6 to 4.8. Drugs acting on CVS and GI system were the most common drugs prescribed. Prescriptions with injections and steroids were less in the study population. All the drugs were prescribed by their generic name and most were present in the essential list of medicines.

scholarly journals Evaluation of cephalosporins utilization and compliance with reference to the hospital antibiotic policy of an Indian tertiary care hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 1044
Author(s):  
Shinu Mary John ◽  
Bijoy Kumar Panda ◽  
Deepak Govind Bhosle ◽  
Nikki Soman
Keyword(s):  
Bacterial Resistance ◽  
Tertiary Care ◽  
General Medicine ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Antibiotic Policy ◽  
Bed Days ◽  
Health Organization ◽  
Tract Infections

Background: Emergence of bacterial resistance in hospital settings due to the liberal use of antibiotics which led to an altered impact on its therapeutic efficacy and outcome, thereby increasing the treatment costs in patients. In this regard the study aims to evaluate the cephalosporins utilization and compliance to the hospital antibiotic policy in general medicine ward.Methods: A prospective observational study was carried out over an eleven-month period in patients prescribed with cephalosporins. Clinical data of inpatients were collected and evaluated by using World Health Organization (WHO) core prescribing indicators and defined daily dose per 100 bed-days. The comparison between the cephalosporins prescribed in the chart records to the recommendations mentioned in the institutional antibiotic policy v.2.0, help to determine the deviations in their usage pattern.Results: A total of 370 patients were enrolled in the study, of which 54.6% were females. Cephalosporins were empirically prescribed in 240 (64.9%) cases. The average number of total antibiotics and cephalosporins per encounter was 1.6 and 1 respectively. Among the total antibiotics, 63.7% were cephalosporins. Third generation cephalosporins (98.4%) were commonly prescribed, with ceftriaxone (93%) in parenteral form for respiratory tract infections (31.9%). Total parenteral antibiotics prescribed were found to be 68.8% of which 88.6% were cephalosporins. Utilization pattern of cephalosporins amounted to be 4.95 DDD/100 bed-days. Overall compliance was achieved in 191 (51.6%) prescriptions.Conclusions: The rate of prescribing of cephalosporins was marginally high. There was a low rate of compliance towards policy which reflects the urgent need for repetitive intervention to comply antibiotic policy.

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

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.

scholarly journals Assessment of drug utilization among geriatric patients based on defined daily dose concept in a rural tertiary care teaching hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1538
Author(s):  
K. Padmavathi ◽  
S. A. Arun Raaj ◽  
S. Subash ◽  
C. K. Dhanapal ◽  
S. Periasamy
Keyword(s):  
Drug Utilization ◽  
Geriatric Patients ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Defined Daily Dose ◽  
College Hospital ◽  
Care Teaching ◽  
Essential Drug List ◽  
Daily Dose ◽  
Collection Form

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines.

scholarly journals A PROSPECTIVE STUDY ON ANTIMICROBIAL UTILIZATION PATTERN IN OUTPATIENT DEPARTMENT AT TERTIARY CARE HOSPITAL, PUNE, INDIA.

2018 ◽  
Vol 11 (5) ◽  
pp. 131
Author(s):  
Sarang A Deshmukh ◽  
Yashasvi Agarwal ◽  
Harshita Hiran ◽  
Uma Bhosale
Keyword(s):  
Antimicrobial Agents ◽  
Demographic Data ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Antibiotic Use ◽  
Oral Dosage ◽  
Fixed Dose ◽  
Care Hospital ◽  
Prescribing Practices ◽  
Cross Sectional

 Objective: The objective of the study was to evaluate antimicrobial prescription pattern in outpatient departments.Method: This was a prospective, cross-sectional and observational study over 12 weeks total 400 prescriptions of either gender and age; containing antimicrobial agents (AMAs) were analyzed for demographic data and the WHO prescribing indicators.Results: Most of prescription were given to men (n=262). The most common group of AMA used was Cephalosporins (n=141, 35.25%); of which Ceftriaxone was most commonly prescribed (n=73, 18.25%). 10 AMAs were from the WHO essential medicine list AMAs. Men outnumbered women in prescribing antibiotics (n=262 vs. 138). Most of AMAs receivers were between 26 and 35 years (n=128, 32%). Amoxicillin+Clavulanic acid fixed-dose combination was most common (n=84, 21%). Most of the prescriptions were containing four drugs per prescriptions (n=130, 32.5%). Only 10% of the prescription was given by generic name and rest 90% were given by brand name. Oral dosage form of AMAs was predominant (n=340, 85%). Vitamins and supplement were most common comedication received by patients.Conclusion: Antibiotic use was found to be reasonable and rational in most of the cases. However, still, prescribers should improve prescribing practices and make it more rational.

scholarly journals DRUG UTILIZATION STUDY IN OPHTHALMOLOGY OUTPATIENT DEPARTMENT IN A GOVERNMENT TERTIARY CARE HOSPITAL IN MAHARASHTRA

2018 ◽  
Vol 11 (7) ◽  
pp. 167
Author(s):  
Nishandar Tb ◽  
Kale As ◽  
Pise Hn ◽  
Jambhrunkar Sd
Keyword(s):  
Drug Utilization ◽  
Drug Exposure ◽  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Age Group

Objective: Drug utilization research is an essential part of pharmacoepidemiology as it describes the extent, nature, and determinants of drug exposure. Indiscriminate use of topical antibiotics, steroids, and nonsteroidal anti-inflammatory drugs causes histological and structural changes in the conjunctiva. The present study was proposed to investigate prescription and drug utilization practices in ophthalmology outpatient department (OPD) in a government tertiary care hospital in Maharashtra.Methodology: An observational, cross-sectional study was conducted in a tertiary care teaching hospital of rural Maharashtra, India, from January 2015 to June 2016 after approval of the institutional ethics committee. Patients of all age group and of either gender attending ophthalmology OPD in a tertiary care hospital were included in the study. Patients not willing to consent as well as follow-up patients were excluded from the study. Data collection was done in a predesigned pro forma. Prescriptions were evaluated for demographic data, World Health Organization (WHO) core drug prescription indicators. Statistical analysis was performed using Microsoft Office Excel® 2007.Results: In a total of 600 patients, females outnumbered males. A bit less than a half of patients belonged to the age group of 19–45 years. An average number of drugs per encounter was (1080/600), i.e. 1.8. Of 1080 total drugs prescribed, 678 drugs (62.78%) were prescribed by their generic name. 1027/1080 (95.09%) drugs were prescribed from the National List of Essential Medicines and 671/1080 (62.13%) drugs prescribed were from the WHO- Essential medicines List. Total encounters having antibiotics and injectable formulations were 274 (45.66%) and 4 (0.66%), respectively.Discussion: Drug utilization studies (DUS) are a tool for assessing the prescribing, dispensing, and distribution of drugs. The main aim of DUS is to facilitate rational use of medicines. Overall findings of the study suggest that ophthalmologists’ drug prescribing habits were appropriate to a larger extent in the current setting.

scholarly journals Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

2019 ◽  
Vol 8 (6) ◽  
pp. 1430
Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant
Keyword(s):  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Brand Names ◽  
Outpatient Department ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

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.

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