scholarly journals Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

2020 ◽  
Vol 8 (1) ◽  
pp. 35
Author(s):  
Hetal N. Jeeyani ◽  
Rutvik H. Parikh ◽  
Sheena Sivanandan ◽  
Harsh J. Muliya ◽  
Shivam N. Badiyani ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Antimicrobial Drugs ◽  
Prescribing Indicators ◽  
Inappropriate Use ◽  
Increased Risk ◽  
The Mean

Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

scholarly journals Prescription pattern of antibiotics in paediatric inpatients at a tertiary care hospital in North East India

2017 ◽  
Vol 6 (10) ◽  
pp. 2384
Author(s):  
Sayeri Dutta ◽  
Abhishek Bhattacharjee ◽  
N. Meena Devi
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
World Health Organisation ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Cross Sectional ◽  
North East

Background: Paediatric antibiotic prescription is a major concern in terms of public health since infections are the most frequent cause of childhood disease. The aim of this hospital-based cross sectional study was to assess the pattern of antibiotic use in the paediatric ward of RIMS hospital, Manipur, India.Methods: A retrospective study of six months duration was carried out for the month of October 2016 to March 2017. A total number of 200 patients case sheets were utilized for our study from paediatric in-patients department of RIMS hospital, Manipur. The data collected was then analysed for various prescribing indicators as laid down by world health organisation (WHO) for analysis of drug use parameters.Results: The mean age of paediatric patient was 2.1 years. The average number of drugs per encounter was 5.14. The average number of antibiotic per patient was 2.11. In present study antibiotic were 41% of total drugs prescribed. Most common prevalence of disease among study patients sample was acute gastroenteritis. The most commonly prescribed antibiotic was Ceftriaxone followed by Amikacin. In present study 8.2% of antibiotics were prescribed in generic name. Polypharmacy was evident from the study.Conclusions: Antibiotic prescribing in children is relatively high in RIMS, Imphal, Manipur. Prescription of broad-spectrum antibiotics though has increased demonstrably which   h may result in development of bacterial resistance; however, development of guidelines for antibiotic prescription and use of appropriate drugs for the disease can result in minimizing the unfavourable use of antibiotics in children.

scholarly journals Prescribing Pattern of Antibiotics among Children in a Tertiary-Care Hospital, Bangladesh

2020 ◽  
Vol 41 (S1) ◽  
pp. s356-s356
Author(s):  
Sukanta Chowdhury ◽  
Rajib Sarker ◽  
Md. Shafiqul Islam Khan ◽  
Probir Kumar Ghosh ◽  
Md. Abu Tareq ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Limited Information ◽  
Average Hospital ◽  
Low Resource Settings ◽  
Low Resource

Background: The inappropriate and irrational use of antibiotics both in humans and animals causes bacterial resistance. Bacterial resistance is common in low- and middle-income countries, including Bangladesh. Bangladesh has very limited information on antibiotic use and associated resistance. We sought to better understand antibiotic use in low-resource settings for the development of effective strategies to address inappropriate antibiotic use. Methods: We conducted a cross-sectional study among hospitalized children <5 years of age in a tertiary-care hospital in Barishal, Bangladesh, to collect data on antibiotic use. We collected data from 400 children during February–April 2019. Results: Among these 400 children, >50% were aged <1 year, and >60% of these children were boys. The average hospital stay was 3 days (range, 1–14). Most of the children had history of diarrhea and 18% had pneumonia. Most children (82%) were prescribed antibiotics. A combined form of antibiotics was prescribed for 17% of these children. In total, 14 different antibiotics were used. The most commonly used antibiotic was ceftriaxone (57%) followed by azithromycin (14%). The parental route was mostly preferred (75%) for antibiotic administration. Conclusions: Antibiotic prescription was common in children aged <5 years visiting a tertiary-care hospital. Most of the prescribed antibiotics were broad spectrum, which can promote bacterial resistance. Further studies are needed to identify the factors associated with overuse of antibiotics and bacterial resistance in low-resource settings.Funding: NoneDisclosures: None

scholarly journals Decreasing Clostridium difficile Infections by an Antimicrobial Stewardship Program That Reduces Moxifloxacin Use

2014 ◽  
Vol 58 (9) ◽  
pp. 5079-5083 ◽  
Author(s):  
Judith Maria Wenisch ◽  
Susanne Equiluz-Bruck ◽  
Marta Fudel ◽  
Ingun Reiter ◽  
Andrea Schmid ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Hospitalized Patients ◽  
Care Hospital ◽  
Content Type ◽  
Period 2 ◽  
Defined Daily Doses ◽  
Stewardship Program ◽  
The Mean

ABSTRACTClostridium difficileinfections (CDI) in hospitalized patients are known to be closely related to antibiotic exposure. Although several substances can cause CDI, the risk differs between individual agents. In Vienna and other eastern parts of Austria, CDI ribotype 027 is currently highly prevalent. This ribotype has the characteristic of intrinsic moxifloxacin resistance. Therefore, we hypothesized that moxifloxacin restriction can decrease the number of CDI cases in hospitalized patients. Our antibiotic stewardship (ABS) group applied an information campaign on CDI and formal restriction of moxifloxacin in Wilhelminenspital (Vienna, Austria), a 1,000- bed tertiary care hospital. The preintervention period (period 1) was January through May 2013, and the intervention period (period 2) was June through December 2013. We recorded the defined daily doses (DDD) of moxifloxacin and the number of CDI patients/month. Moxifloxacin use was reduced from a mean (± standard error of the mean [SEM]) of 1,038 ± 109 DDD per month (period 1) to 42 ± 10 DDD per month (period 2) (P= 0.0045). Total antibiotic use was not affected. The mean (±SEM) numbers of CDI cases in period 1 were 59 ± 3 per month and in period 2 were 32 ± 3 per month (46% reduction;P= 0.0044). Reducing moxifloxacin use in combination with providing structured information on CDI was associated with an immediate decrease in CDI rates in this large community teaching hospital.

scholarly journals Prescribing pattern of antibiotics in the department of pediatrics in a tertiary care medical college hospital in Northern India

2014 ◽  
Vol 5 (4) ◽  
pp. 69-72 ◽  
Author(s):  
Ravika Kanish ◽  
Kanchan Gupta ◽  
Shivani Juneja ◽  
HS Bains ◽  
Sandeep Kaushal
Keyword(s):  
Direct Cost ◽  
Pediatric Patients ◽  
Treatment Guidelines ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
North India ◽  
Health Concern ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Prescribing Pattern

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

scholarly journals ANTIBIOTIC USE IN PEDIATRIC INFECTIONS; A STUDY IN TERTIARY CARE HOSPITAL

2018 ◽  
Vol 4 (4) ◽  
pp. 26-32
Author(s):  
Praveena Gungam ◽  
Y. Sunil Kumar Yadav ◽  
Sunil Junapudi
Keyword(s):  
Adverse Drug Reactions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Drug Reactions ◽  
Parenteral Route ◽  
Antibiotics Use ◽  
Pediatric Infections

Objectives: Antibiotics are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in south India, to make a profile of antibiotics use and suspected adverse drug reactions (ADRs) owing to them. Methods: Hospitalized children of either sex, aged between 1 month and 12 years, were inspected. Baseline demographic and clinical features, duration of hospital stay, antibiotics received in hospital along with dosing and indications and interest of suspected ADRs attributable to their use were recorded. Every patient was followed up till discharge, admission to the Pediatric Intensive Care Unit, or passing. Results: Over the year and a half report period 364 confirmations were screened. The prevalence of Antibiotics use was 80.22%. The majority of the 292 children who received Antibiotics were males (63.35%). Median age was 35 months, five children died. In most instances, either two (41%) or a single antibiotic (37.32%) was used. Ceftriaxone, co-amoxiclav, amikacin, vancomycin, and ampicillin were predominantly used. Antimalarials, antivirals and antiprotozoals were used occasionally. Average number of Antibiotics per patient was 2.2± 1.1 the majority (81.15%) were by parenteral route and initial choice was usually empirical. Prescriptions were usually in generic name. The antibiotic treatment went somewhere in the range of 1 and 32days, with a middle of 8 days. Five ADRs were noted of which half were skin rash and the rest loose stools. Conclusions: The profile of Antibiotic utilize is comprehensively like prior Indian investigations. Apparent overuse of multiple Antibiotics per prescription and the parenteral route requires exploration. Antibiotics are being used empirically in the absence of policy. ADRs to Antibiotics are occasional and usually mild. The benchmark information can serve in situation analysis for antibiotic prescribing guidelines.Keywords: Antibiotic; Pediatric infections; Adverse drug reactions; Tertiary care hospital.

scholarly journals Prescription Patterns of Antimicrobial Drugs in Hospitalized Patients in Tertiary Care Hospital of Kathmandu

2016 ◽  
Vol 15 (1) ◽  
pp. 52-60
Author(s):  
Binod Raut ◽  
Anjan Khadka ◽  
Rabindra Nath Borah
Keyword(s):  
Tertiary Care Hospital ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
Care Hospital ◽  
Antimicrobial Drugs ◽  
Prescription Pattern ◽  
Key Factor ◽  
Duration Of Hospitalization ◽  
Study Population ◽  
The Mean

Introduction: Antimicrobial drugs are one of the most commonly prescribed drugs in hospital. Overuse and irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. Use of irrational and unnecessary antimicrobials remains common in the developing countries.  This study was conducted to analyze the prescription pattern of antimicrobials in the department of internal medicine of tertiary care hospital. Methods: Antimicrobials are among the most commonly prescribed drugs in hospital. Overuse and irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. Use of irrational and unnecessary antimicrobials remains common in the developing countries.  This study was conducted to analyze the prescription pattern of antimicrobials in the department of internal medicine of tertiary care hospital. Results: The mean duration of hospitalization among the study population was 5 days. Of the 460 medicines prescribed, mostly indicated for respiratory infections, and the most common antibiotic was from the group cephalosporin 209 (69.7 %).  55 % of prescriptions include only one drug, 39 % with two drugs and 6% with three or more than three drugs. Conclusion: The mean duration of hospitalization among the study population was 5 days. Of the 460 medicines prescribed, mostly indicated for respiratory infections, and the most common antibiotic was from the group cephalosporin 209 (69.7 %). 55 % of prescriptions include only one drug, 39 % with two drugs and 6% with three or more than three drugs.

scholarly journals Association of Serum LDL Cholesterol Level with Periodontitis among Patients Visiting a Tertiary-care Hospital

2011 ◽  
Vol 51 (183) ◽  
Author(s):  
S Sharma ◽  
M Lamsal ◽  
SK Sharma ◽  
SR Niraula ◽  
B Koirala
Keyword(s):  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Serum ◽  
Care Hospital ◽  
Clinical Attachment Loss ◽  
Attachment Loss ◽  
Increased Risk ◽  
The Mean

Introduction: High low-density lipoproteins (LDL) cholesterol is one of the major risk factors for cardiovascular disease. In recent years, some evidence has been presented that periodontitis,an infectious inflammatory condition of the periodontium, is associated with an increased risk of cardiovascular disease. To further elucidate this association, we have studied the levels of LDL cholesterol, a known risk marker for cardiovascular disease, in a periodontally-diseased group. Methods: The levels of serum LDL cholesterol in 47 subjects with mild to severe (clinical attachment loss equal to or greater than 1 mm) chronic generalized (at least 30% of teeth affected) periodontitis with the mean age of 42.21 ± 1.46 years were measured and compared with those obtained from 42 age (39.83 ± 0.94) and sex matched controls. Both groups were free from systemic illnesses. Results: The mean serum LDL cholesterol in periodontitis patients was found to be signifi cantly higher (P < 0.001) as compared to that of the controls. The mean clinical attachment loss was positively correlated with serum LDL cholesterol (P < 0.01) and gingival index (P<0.05). The frequency of persons with pathologic values of LDL cholesterol was signifi cantly higher in periodontitis patients compared with that of the controls. Conclusions: These results showed that high serum LDL cholesterol may be associated with periodontitis in healthy people. However, it is unclear whether periodontitis causes an increase in the levels of serum LDL or an increased LDL is a risk factor for both periodontitis and cardiovascular disease. Keywords: Cardiovascular disease, LDL cholesterol, periodontitis.  

scholarly journals A prospective study on the pattern of antibiotic use in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 2237
Author(s):  
Susan Mani ◽  
T. S. Hariharan
Keyword(s):  
Bacterial Resistance ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Brand Names ◽  
Encounter Rate ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Seriously Ill Patients

Background: Indiscriminate use of antimicrobials is rampant throughout India, and this is a matter of serious concern. There are several reports linking antibiotic usage to bacterial resistance. Towards addressing this problem, community wise surveillance needs to be undertaken to monitor antibiotic exposure including their misuse. This study was meant to assess the extent and pattern of antibiotic use in a tertiary care facility.Methods: Subjects for study were patients attending a suburban hospital in central Kerala. Case records of patients who were prescribed systemic antibiotics were perused for relevant data. Seriously ill patients were excluded from the study.Results: 610 encounters with antibiotics could be identified from a total of around 2000 patient records, indicating an encounter rate of 29%; which is quite acceptable as per the WHO standard of prescribing indicators. However, more than 70% of prescriptions carried only brand names of medications. Use of antibiotics was mostly on the basis of clinical symptoms (presumptive), and culture reports were not given due credence. Prescriptions were invariably therapeutic in nature, and the concepts of surgical prophylaxis conveniently given a go by. The most common infections were those of the Upper Respiratory Tract (URTI), followed by skin and soft tissue infections. Ampicillin, azithromycin and cefuroxime were the most frequently prescribed agents. More than one third of infections were treated with a combination of antimicrobials. A general temptation for using cephalosporin - betalactamase inhibitor combinations could be related to the aggressive promotional policies of the pharmaceutical industry.Conclusions: The overall antibiotic encounter rate is acceptable as per WHO standards. But the tendency for using injections as well as antibiotic combinations is very high. Prophylactic use of antibiotics in surgical procedures is not being followed at all. A serious attempt needs to be made to implement National Guidelines for use of antimicrobials.

scholarly journals Clinico epidemiological study of thermal burns in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 759
Author(s):  
Ravikumar G. ◽  
Shanmugapriya P. ◽  
Sugapradha G. R. ◽  
Senthamilselvi R.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hypovolemic Shock ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Increased Risk ◽  
First Aid Training ◽  
Mortality Ratio ◽  
The Mean

Background: Substantial number of people suffers from burn injuries every year in India that make the patients endure disease, surgeries and years of rehabilitation. The higher mortality and prolonged morbidity results in heavy social, economic and clinical burden to the nation. The objective was to study and analyse the socio-demographic profile of burn patients in addition to evaluate the causes, manner and clinical course of burn patients along with its outcome.Methods: This was a registry based retrospective study on 114 burns patients, admitted in a Tertiary Care Hospital in South India from January 2018 to June 2018. Data were collected and assimilated comprehensively.Results: The age group of patients ranged from 13-70 years, the mean age being 29 years. The overall male, female to transgender ratio was 0.57:1:0.01. Most of the patients were married (66.66%). The TBSA involvement in burns ranged from 10% to 100% and the mean TBSA was found to be 11.4±2.95. A higher TBSA involvement is associated with an increased risk of mortality and this association between TBSA and mortality was found to be statistically significant (p<0.05). Mortality ratio in this study was 51.75% and septic shock (58%) was the most common cause of death followed by hypovolemic shock (42%).Conclusions: Burns are one of the leading causes of preventable morbidity and mortality, provided the prevention strategies address the hazards of specific burn injuries, awareness education for vulnerable population and targeted first aid training. 

A Study on prescribing pattern of drugs in orthopaedic in-patient department at a tertiary care hospital in Guntur region

2020 ◽  
Vol 8 (2) ◽  
pp. 60-70
Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Delivery ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Prescribing Pattern ◽  
Prescribing Indicators ◽  
Bed Days

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.

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