scholarly journals A prospective observational study on prescribing pattern of antimicrobial agents in the post-operative general surgery ward of a tertiary care teaching hospital

Author(s):  
Velvizhy R. ◽  
Johan J. Pandian

Background: This prospective observational study was done to know the current prescription trend of antimicrobial agents in the post-operative ward. To evaluate the current pattern of antimicrobial agents in the post-operative surgical cases of a tertiary care teaching hospital.Methods: The study was carried out in collaboration with the Department of General Surgery and Department of Pharmacology during April 2013 to March 2014. All parameters like demographic data, antimicrobials agents prescribed by surgeons, dose, frequency, duration, route, formulation, brand or generic drugs, adverse events were collected in the specially structured case proforma. Descriptive statistics was applied using SPSS version 17.0.Results: During the study period, 513 patient case records were analysed in which males are higher than females. A total of 816 drugs were used in 484 patients during the study period. 162 were on a single drug, 190 were on two drugs, 42 were on three drugs and 90 were on fixed dose combination. Brand name of the drugs and parenteral route of administration were preferred in the study. Cephalosporins (52.32%) and metronidazole (34.38%) were the most commonly prescribed group of antimicrobials followed by penicillin (0.9%), aminoglycosides (6.58%), quinolones (5.23%), macrolides (0.45%) and tetracycline (0.14%). Totally 135 (27.89%) patients received drugs which are not included in the essential medicine list of WHO and 112 (23.14%) patients received drugs which are not from national EML.Conclusions: The maximum prescribed antimicrobial agent in the post-operative ward was third generation cephalosporins.

Author(s):  
Velvizhy R. ◽  
Johan Pandian J.

Background: Fixed dose drug combinations (FDCs), are combinations of two or more active drugs. It should be used when the combination has an established advantage over single drug in efficacy, safety and compliance. The World Health Organization (WHO) lists only 19 of such combinations. But Indian market is filled with hundreds of FDCs which were not approved leading to irrational use. This study was focused on finding out the fixed dose combination of antimicrobial agents used in the post-operative general surgery ward of a tertiary care teaching hospital.Methods: After getting approval from institutional human ethics committee the prescriptions of patients admitted during April 2013 to March 2014 were analyzed. Demographic data, FDC prescribed by surgeons, Dose, Frequency, Duration, Route, Formulation, Brand or generic drugs, Adverse events due to use of FDC were collected and SPSS version 17 was used for statistical analysis. Fixed dose combinations were used in 90 Patients. The most commonly used FDC were ampicillin with Cloxacillin (43) followed by amoxicillin with clavulanic acid (22), cefoperazone with sulbactam (19) and piperacillin with tazobactam (6). A common drug used in combination along with FDC was metronidazole and aminoglycoside. The irrational combination seen in this study was ampicillin with Cloxacillin (8.88%) of the total FDC which is not approved by DCGI or FDA.Results: In this study out of 145 drugs used, 41drugs were administered three times a day, 90 drugs were given two times a day and 14 drugs were given once a day dosing. 53 patients received FDCs for prophylaxis and 37 patients for treatment purpose. All FDCs were prescribed in brand names. No adverse drug reaction was observed in this study.Conclusions: Consultants should undergo continuing medical education (CME) on newer drug combinations and their adverse drug reactions which will be evidence-based rather than to rely on representatives.


Author(s):  
Sarang A Deshmukh ◽  
Yashasvi Agarwal ◽  
Harshita Hiran ◽  
Uma Bhosale

 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.


Author(s):  
Bhaskar H. Nagaiah ◽  
Shivaraj Basavaraj Patil ◽  
Nallavelly Vahila ◽  
Y. Venkata Rao ◽  
Shrinivas R. Raikar ◽  
...  

Background: ADRs are iatrogenic diseases, escalates the burden of health care system by increasing the morbidity and mortality and also additional cost of ADRs management to patients.Methods: A prospective observational study was conducted over 1 year from January 2015 to December 2015. The yellow forms dropped in the red ADR boxes are collected and ADRs due to antimicrobials were analyzed for demographic data, causality, severity, drugs implicated, and organ system affected. The data were presented as counts and percentages.Results: Cephalosporins were the most common antimicrobial class implicated in ADRs, and the dermatological system was the most common system affected by ADRs. All the reactions either belonged to the probable or possible category. Majority of reactions were non-serious.Conclusions: Regular prescription auditing and awareness about polypharmacy will further reduce ADRs due to antimicrobials.


Author(s):  
Vandana Badar ◽  
Vidisha Parulekar ◽  
Priti Garate

Objectives: The objectives of the study were as follows: (1) To study the prescription patterns in Respiratory tract infections (RTI) in indoor patients in pediatric wards. (2) To check the rationality of treatment according to Modified Kunin’s rationality criteria. (3)To analyze the data of RTI by Anatomical Therapeutic Chemical classification.Methods: It was a non-interventional, prospective, observational study which was conducted in indoor pediatric patients in a tertiary care teaching hospital in India. Data were analyzed and evaluated according to the WHO rational use of drugs guidelines.Study sample: The study sample was 174.Study duration: The study duration was August 15, 2016–September 15, 2016.Results: Males (63.79%) were more as compared to females (36.20%), and the highest number of cases was seen in infants (62.06%). Acute bronchiolitis (54.02%) was highest in the incidence followed by Wheeze Associated Lower Respiratory Tract Infection (WALRI) (30.45%). The average duration of patient stay in hospital was 4.71 days whereas 93.33% were polytherapy and mostly prescribed antibiotic was amoxicillin-clavulanic acid in acute bronchiolitis and WALRI. Salbutamol (40.84%) and Ipratropium Bromide (39.43%) were the commonly prescribed respiratory medicines. Oral route (42.27%) was the most common route of administration. 56.11% drugs were prescribed by generic name.Conclusion: Standard treatment guidelines for the treatment of RTI need to be urgently developed and strictly implemented.


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