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

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):  
DHANYA T H ◽  
SANALKUMAR K B ◽  
ANDREWS M A

Objectives: The objectives of the study were to study the pattern of major drug groups prescribed, assess the Rational Prescription pattern by measuring the WHO Core Prescribing Indicators and to assess the quality of the prescriptions by assessing the legibility of prescription in the outpatient department of a tertiary care hospital. Methods: It was an analytical cross-sectional study done in hospital pharmacy for a period of 6 months. Approval from Institutional Research Committee and Institutional Ethics Committee was taken before starting the study. Sample size was taken as 1020. Results: One hundred and twenty prescriptions were analyzed. About 49% prescriptions were of males and 54% of females. Mean age of the patients were 46 years. A total of 3557 medicines were prescribed in 1020 prescriptions. Due to lack of legibility, we were unable to decode 122 medicines out of 3557 medicines prescribed. The dosage forms prescribed were; oral 87.4%, injections 1.4%, inhalational agents 0.4%, and topical agents 10.8%. Average number of medicines per prescription was 3.5. Percentage of medicines prescribed by generic name was 45%. Percentage of antibiotics per prescription was 24.8%. Percentage of injections per prescription was 4.8%. Percentage of medicines prescribed as per NATIONAL essential drugs list (EDL) was 3.2% and as per the WHO EDL was 2.6%. Percentage of fixed dose combinations (FDCs) was 6.5%. Conclusion: It was evident that polypharmacy was present as indicated by the average number of medicines prescribed. Medicines prescribed by generic name and from Essential Medicine List were less in number. Antibiotics and injections prescribed was in conformity with the WHO recommended values, which means that there was no irrational use of antibiotics and unwanted use of injectables. Percentage of FDCs was 6.5%. Most commonly prescribed drug was Ranitidine as per our study. Hence, as per this study, prescribers did not follow prescribing core indicators of the WHO closely, except for two indicators. The quality of prescriptions with respect to legibility and clarity was found to be optimal.


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):  
Krishnan Vengadaragava Chary ◽  
Rithu Bhaskaran

Objective: To critically analyze the essentiality and irrational zinc preparations available in Indian market. Methods: This was conducted as cross-sectional analysis by department of pharmacology of our tertiary care hospital between June and December 2016. Data regarding various formulations of zinc were retrieved from current index of medical sciences and drug India database. Rationality assessment was done using prescribed guidelines and approved formulations of zinc by Central drug standard control organisation. Essentiality was checked using National list of essential medicine India, 2013 and latest version of WHO list essential medicine bulletin. Dosage regulation was assessed using Indian pharmacopeia guidelines, National institute of nutrition, India recommendation and upper daily intake toxicity intake, United States of America (USA)Results: Our study results showed wide variation in the number of zinc preparation. Total number of formulation available in the market is 335. Among zinc preparation, the preparation that contains 20 mg of zinc as recommended by various guidelines is 10 in number. About 325 preparations of zinc are added with one or more nutraceuticals. None of these fixed dose combination of zinc containing preparation is recommended as essential fixed regimen.Conclusion: Zinc has lot of relevance in treating recurrent diarrhoeal illness, especially in paediatric cases; however legal, regulatory and educational measures should be followed to curtail all the irrational zinc prescription development, promotion, marketing and prescription.


Author(s):  
Sartaj Hussain ◽  
Kamal K. Sawlani ◽  
Suraj S. Yadav ◽  
Sanjay Khattri

Background: The antimicrobial resistance is increasing globally and, concurrently, downward trend in development of newer antibiotics is leading to a serious public health problem and economic consequences.Methods: Prescriptions with at least one antimicrobial were included in the study. A total of 242 prescriptions were included in the study. The antimicrobials were classified into different classes based on WHO-ATC classification.Results: A total of 281 antimicrobials prescribed in 242 prescriptions with an average of 1.16 per prescription. In most of the prescriptions, 1 antimicrobial were prescribed (88.43%). The routes of the antimicrobial administration were mostly oral 268 (95.37%) followed by injectable 13 (4.63%). The most commonly prescribed classes of antimicrobial in this study were antibacterials for systemic use (J01) (74.02%) followed by antimycobacterials (J04) (13.88%), antiparasitic drugs (P) (8.19%), antimycotics for systemic use (J02) (2.49%) and antivirals for systemic use (J05) (1.42%). Among antibacterials, the most commonly prescribed classes of antibacterial was various antibacterial FDCs (19.22%), followed by quinolones (18.86%), macrolides (18.15%), β-lactams (11.03%) cephalosporins (6.76%), penicillins (4.27%), aminoglycosides (2.84%), metronidazole (1.78%), clindamycin (1.78%) and tetracycline (0.36%). The total percentage of antimicrobials prescribed as Fixed Dose Combinations (FDCs) were 32.38%.Conclusions: The present study has reported that most commonly prescribed antimicrobials were quinolones followed by macrolides and β-lactams. Recommendations to change the ongoing prescribing practices should be based on the Standard Treatment Guidelines, EDL and Antibiotic policy or by following the information, education, and communication (IEC) interventions.


2020 ◽  
Vol VOLUME 8 (ISSUE 2) ◽  
pp. 13-16
Author(s):  
Anitya Srivastava

Abstract Context: Chronic Suppurative Otitis Media (CSOM) is a commonly encountered middle ear disease resulting in morbid complications and squeals. It is broadly classied into safe and unsafe type; in which unsafe CSOM is commonly associated with complications due to the bone erosion effect of cholesteatoma and super added infections. The rise in antibiotic use has reduced the incidence of complications but the current practice of unscientic administration of antimicrobial agents has made the microbiome resistant, ironically increasing the rate of certain complications. Aim: This study was conducted to prole the complications in unsafe CSOM. Material and Methods: A record based cross sectional study was conducted between January 2015 and October 2018 on 241 cases of unsafe CSOM at a tertiary care hospital in North India. Results: Out of 241 cases 14% presented with complications. Of these 76.6% had extra c ranial compli cation and 23.33% had intracranial complications. Conclusion: Mastoid abscess and meningitis were the most frequently encountered extra and intra cranial complications respectively. Judicious use of antibiotics will go a long way in reducing the morbidity due to the disease. Keywords: CSOM; Extra cranial complications; Intra cranial complications.


2019 ◽  
Vol 6 (9) ◽  
pp. 3117
Author(s):  
Shyam Sundar Tandri ◽  
Ayathu V. S. Sai Mahesh

Background: Thyroid nodules are a common finding in general practice. These nodules are either solitary or multinodular. In the present study thorough evaluation of all the cases presenting with a solitary thyroid nodule (STN) is done. The clear overview of prevalence of STN, associated risk factors, its distribution and its percentage of malignancy, clinic-pathological correlation and findings on ultra-sonogram.Methods: A one year cross sectional study at a tertiary care hospital was done after ethical committee approval. All cases of thyroid with solitary thyroid nodule were included and socio demographic data, clinical examination and USG data was noted. Thyroid hormone profile, FNAC and HPE was performed for every case enrolled and data was noted. The data was analyzed using SPSS version 22.Results: 350 cases were enrolled with 44.42% prevalence and 61.43% were females. Maximum age group was 31-40 years with swelling as the most common sign. 81.14% were euthyroid, 6.3% of cases had lymph node involvement. Micro calcification in 69.7% of nodules and 78.65 were solid. 40.3% of the STN were of colloid on FNAC and 6% were malignant. Malignancy on HPE was 14.6% and papillary carcinoma was the most commonest and follicular least.Conclusions: All cases of STN require a thorough clinical approach supported by ultra-sonogram, FNAC and detailed HPE after surgery for evaluation of benign and malignant lesions. Fine needle aspiration cytology has become an invaluable, minimally invasive and reliable tool in the preoperative assessment of patients with suspicion of malignancy.


2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Aashish Kumar Bhattarai ◽  
Anna Acharya ◽  
Prabin Kumar Karki

Introduction: Lipids contribute to atherosclerosis and obesity that can lead to different cardiovascular diseases. Statins are hydroxymethylglutaryl reductase inhibitors that effectively lower the cholesterol level. It is widely prescribed in the treatment of hypercholesterolemia. Thus it optimizes the lipoprotein profile. The selection of a particular drug by the practitioner should be primarily based on clinical outcome. This study was conducted to find the type of statins that are most preferred by the doctors for treating dyslipidemia and preferred the fixed-dose in a tertiary care hospital. Methods: This was a descriptive cross-sectional study conducted among the practicing doctors of Kathmandu Medical College from July to August 2020. Ethical approval was taken from the Institutional Review Committee of the college (Ref: 207202006). Convenient sampling was done. A semi-structured questionnaire was used with consent. The data were analyzed with Social Statistical Package for the Social Sciences version 20. Results: Statins, with the score 4.25 was accounted for most preferred for the treatment of dyslipidemia. Among different statins, atorvastatin with a score of 4.48 was most popular followed by rosuvastatin 2.9 score and simvastatin 2.1 scores. Conclusions: Statins were the most preferred agents for the treatment of dyslipidemia. Although different types of statins ought to have similar efficacy in treating dyslipidemia, atorvastatin was found to be popular and the most commonly prescribed one. The most common side effect reported with statins was myopathy.


2021 ◽  
pp. 191-194
Author(s):  
Kishore M S ◽  
Narendra Kumar ◽  
S Sindhu

Background: The expanding and challenging eld of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Psychotropic drugs utilization in actual clinical practice, effectiveness and safety in the real-life situation needs continuous study. Therefore, the study was undertaken to analyze the prescription pattern of psychotropic drugs. Methods: A Cross sectional study was conducted in the psychiatry out-patient department of a tertiary care hospital for 4 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Psychotropic drugs constituted 74.85% of the prescribed medication. Average number of the psychotropic drugs per prescription was 2.53. Percentage of prescriptions with injectable drugs accounted for 5.13%. 59.28% of the drugs were prescribed by generic names, while the rest were branded. 28% of prescriptions contained psychotropic FDCs (Fixed dose th combination). 78.65% of the drugs were from the WHO's 18 List of Essential Medicines. Among the total psychotropic drugs prescribed, antipsychotics (43.87%) were the most commonly prescribed class of drugs followed by antidepressants (23.32%), anxiolytics (22.13%) and the mood stabilizers (9.88%) were the least. Conclusions: Prescription pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. Antipsychotics were the most commonly prescribed psychotropic drugs.


2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67


2016 ◽  
Vol 12 (2) ◽  
pp. 66-70
Author(s):  
Md Shameem Haidar ◽  
Md Abdur Razzak

Introduction: The seronegative arthritis is a heterogeneous group of inflammatory rheumatic diseases with predominant involvement of axial, peripheral joints and enthesitis. All of these have some distinct as well as some overlapping features, characteristic peripheral asymmetrical lower limb involvement and a negative rheumatoid factor. Involvement of joints is usually oligoarticular but rarely polyarthritis may be present. Diagnosis is usually made from clinical features rather than investigations. Objective: To evaluate the seronegative arthritis clinicopathologically by collecting and analyzing the relevant informations. Materials and Methods: A descriptive cross-sectional prospective study was conducted at Combined Military Hospital, Chittagong from November 2015 to October 2016. A total 74 patients of suspected seronegative arthritis were included. Detail socio-demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously to confirm the aetiology of seronegative arthritis. Results: Maximum number of patients was in the 3rd to 4th decade (62.1%), mean age of the patient was 37.4±8.7 and 38.7±8.1 years in male and female respectively. Malefemale ratio was 2.65:1. Symmetrical sacroiliitis was found in 15(20.2%) patients, asymmetrical sacroiliitis in 36(48.6%) and in 23(31.2%) cases sacroiliac joint was not involved. Common aetiology for seronegative arthritis showed that, reactive arthritis recognized in majority of patients 29 (39.1%) and second most common cause was seronegative rheumatoid arthritis in 23(31%) patients. Conclusion: The Seronegative arthritis is a social, economical and health-care burden. Patients who develop 66 JAFMC Bangladesh. Vol 12, No 2 (December) 2016 arthritis have high disability, discomfort and loss of quality of life. Seronegative arthritis is an interesting group of related conditions with overlapping features and genetic and familial association. That may alert the primary care physician to attain possible diagnosis of spondyloarthritis and to consider a rheumatological opinion. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 66-70


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