scholarly journals PROSPECTIVE OBSERVATIONAL STUDY ON ANTIBIOTIC-PRESCRIBING PATTERN AND MEDICATION ERRORS IN SURGICAL PROPHYLAXIS IN A SPECIALTY HOSPITAL

2019 ◽  
pp. 47-50
Author(s):  
SENTHIL KUMAR N ◽  
SIVASAKTHI K ◽  
JISA ELIZABETH JOSEPH ◽  
VISHNUKUMAR VA ◽  
GEOLIN RP
Keyword(s):  
Observational Study ◽  
Sample Size ◽  
Medication Errors ◽  
Prospective Observational Study ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Surgical Prophylaxis ◽  
Prescribing Pattern ◽  
Antibiotic Drug ◽  
Specialty Hospital

Objective: The objective was to study the antibiotic-prescribing patterns, identify the medication errors and impact of surgical antimicrobial prophylaxis (SAP) in preventing surgical site infection (SSI), and to understand the prescribers’ adherence to surgical prophylaxis guidelines. Methods: The study was conducted for a period of 6 months in all surgical departments of a specialty hospital. Data were collected from inpatients records. Australian guideline for SAP was used to assess the appropriateness in prescribing pattern. The sample size was calculated using Raosoft sample size calculator. Results: A prospective observational study was carried out among 178 patients. Of which, 100 were male and 78 were female. Four hundred and thirty-three antimicrobials were prescribed as pre- and post-operative surgical prophylaxis, among that 87% prescribed by brand name and 13% by generic. Seventy-one percent received single antimicrobial agent preoperatively, of which 99.5% prescribed as parenteral and 0.5% as oral formulation. Most often prescribed antibiotic was cefoperazone (28%) of cephalosporin group. Only 5.6% of cases had compliance with SAP guidelines. In this study, 11 patients affected with SSI due to inappropriate antibiotic selection and non-adherence to prophylactic antibiotic guidelines. Conclusion: The present study revealed that there is a poor compliance to SAP guidelines in terms of inappropriateness in antibiotic drug selection, dose, duration, and omission of drugs. Inappropriateness and non-compliance are mainly due to unavailability of clinical pharmacist to assist the physicians in the selection and administration of correct choice of prophylactic drug and unavailability of proper national or local guidelines. Hence, there is dire need to make local SAP guidelines to improve SAP-prescribing pattern.

scholarly journals Prescribing Pattern of NSAIDs Used in Orthopedic Out Patient Department in Two Tertiary Hospitals in Mymensingh

2020 ◽  
Vol 27 (2) ◽  
pp. 195-198
Author(s):  
Tasmin Shahnaz ◽  
Kazi Afzalur Rahman ◽  
AHM Mostafa Kamal ◽  
Habibun Nahar ◽  
Sabrina Shammi Shahnewaz ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Medical College Hospital ◽  
Prescribing Patterns ◽  
Community Based ◽  
Prescribing Pattern ◽  
College Hospital ◽  
Medical College ◽  
Tertiary Hospitals ◽  
Patient Department

Context: Non-steroidal anti-inflammatory drugs (NSAIDs) are most commonly used drugs for years for management of pain and inflammation with good efficacy. NSAIDs are increasingly used for variety of indications like rheumatoid arthritis (RA), osteoarthritis (OA), low back pain (LBP) etc. Prescribing patterns need to be evaluated periodically to increase the therapeutic efficacy, decrease adverse effects and provide feedback to prescribers. A prospective observational study was conducted among patients attending the Out Patient Department (OPD) of Orthopedic and received prescription for NSAIDs in the Mymensingh Medical College Hospital (MMCH) and Community Based Medical College Hospital (CBMCH) in Mymensingh. Material and Methods: The study was carried out on 300 (three hundreds) prescriptions for NSAIDs from orthopedic Out Patient Department (OPD) of Mymensingh Medical College Hospital (MMCH) and Community Based Medical College Hospital (CBMCH). A prospective observational study was conducted from January 2015 to December 2015. Data were collected only from the patients prescribed for NSAIDs and prescribing pattern of NSAIDs were analyzed using SPSS method version 20.1 Results: In case of orthopedic OPD patients most common NSAIDs prescribed to the patients was aceclofenac (29.33%). Others NSAIDs prescribed to the patient in pain management were ketorolac (10%), etoricoxib(8%), ibuprofen (9%), naproxen(9%), sulindac (7%) in orthopedic out patients of both Medical College Hospitals. Most of the NSAIDs were prescribed in brand name (85.34%) where only (14.76%) were prescribed in generic name in both hospitals. Conclusion: From the study it was observed that aceclofenac was the most common NSAIDS used in orthopedic OPD of CBMCH and indomethacin was the most common used NSAIDs in MMCH. Other used NSAIDs were ketorolac, naproxen, etoricoxib, ibuprofen and sulindac. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 195-198

scholarly journals Evaluation of prescribing patterns in a German network of CAM physicians for the treatment of patients with hypertension: a prospective observational study

2009 ◽  
Vol 10 (1) ◽  
Author(s):  
Elke Jeschke ◽  
Thomas Ostermann ◽  
Horst C Vollmar ◽  
Matthias Kröz ◽  
Angelina Bockelbrink ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Prescribing Patterns

Perioperative Medication Errors and Adverse Drug Events

2018 ◽  
pp. 138-142
Keyword(s):  
Observational Study ◽  
Medication Errors ◽  
Prospective Observational Study ◽  
Adverse Drug Events ◽  
Perioperative Period ◽  
Anesthesia Care ◽  
Perioperative Medication

This case focuses on medication errors and adverse drug events occurring during the perioperative period by asking the question: What are the rates, types, severity, and preventability of medication errors (MEs) and adverse drug events (ADEs) in the perioperative setting during anesthesia care? This prospective observational study reported that approximately 1 in 20 perioperative medication administrations, and every second operation, resulted in an ME and/or an ADE. These rates are markedly higher than those reported by prior retrospective surveys. Process- and technology-based solutions may address the root causes of MEs to reduce their incidence.

Antimicrobial Use in Outpatient Hemodialysis Units

2013 ◽  
Vol 34 (4) ◽  
pp. 349-357 ◽  
Author(s):  
Graham M. Snyder ◽  
Priti R. Patel ◽  
Alexander J. Kallen ◽  
James A. Strom ◽  
J. Kevin Tucker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Prospective Study ◽  
Prospective Observational Study ◽  
Chronic Hemodialysis ◽  
Fourth Generation ◽  
Antimicrobial Use ◽  
National Guidelines ◽  
Surgical Prophylaxis ◽  
Narrow Spectrum

Objective.To quantify and characterize overall antimicrobial use, including appropriateness of indication, among patients receiving chronic hemodialysis.Design.Retrospective and prospective observational study.Setting.Two outpatient hemodialysis units.Patients.All patients receiving chronic hemodialysis.Methods.The rate of parenteral antimicrobial use (number of doses per 100 patient-months) was calculated retrospectively from September 2008 through July 2011. Indication and appropriateness of antimicrobial doses were characterized prospectively from August 2010 through July 2011. Inappropriate administration was defined as occasions when criteria for infection based on national guidelines were not met, failure to choose a more narrow-spectrum antimicrobial on the basis of culture data, or occasions when indications for surgical prophylaxis were not met.Results.Over the 35-month retrospective study period, the rate of parenteral antimicrobial use was 32.9 doses per 100 patient-months. Vancomycin was the most commonly prescribed antimicrobial, followed by cefazolin and third- or fourth-generation cephalosporins. Over the 12-month prospective study, 1,003 antimicrobial doses were prescribed. Among the 926 (92.3%) doses for which an indication for administration was available, 276 (29.8%) were classified as inappropriate. Of these, a total of 146 (52.9%) did not meet criteria for infection, 74 (26.8%) represented failure to choose a more narrow-spectrum antimicrobial, and 56 (20.3%) did not meet criteria for surgical prophylaxis. The most common inappropriately prescribed antimicrobials were vancomycin and third- or fourth- generation cephalosporins.Conclusions.Parenteral antimicrobial use was extensive, and as much as one-third was categorized as inappropriate. The findings of this study provide novel information toward minimizing inappropriate antimicrobial use.

scholarly journals Drug utilisation evaluation of antiplatelet agents in a tertiary care teaching hospital-a prospective observational study

2021 ◽  
pp. 218-229
Author(s):  
Rishitha Reddy P ◽  
Prathul P ◽  
Jayalakshmi A ◽  
Anusha SB ◽  
Randeep Raj V.C
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
General Medicine ◽  
Antiplatelet Agents ◽  
Bleeding Risk ◽  
Prescribing Pattern ◽  
Co Morbidity ◽  
Social Habits ◽  
Ischemic Events

Background: Cardiovascular and cerebrovascular diseases were becoming predominant cause of morbidity and mortality in India. Antiplatelet agents remain as the cornerstone therapy for acute thrombotic coronary syndromes, IHD, STROKE, CHD and PCI and are essential for thromboprophylaxis. The current study was undertaken to evaluate the drug use pattern of antiplateletagents and to study the prescribing pattern, observe co-morbid conditions, social habits [alcohol/smoking], adverse events and drug-drug interactions associated with antiplatelet agents. Methods: A prospective observational study was conducted at MIMS hospital, study population of 160 inpatients from cardiology, general-medicine and neurology departments. Data was analyzed in Microsoft excel. Results: Data records obtained from 160 patients in which 51.87% were females followed by males 48.125%. most patients with IHD and stroke were found in age group 50-70 years. Hypertension was most found co-morbidity among the patients [61.88%] followed by diabetes [34.38%], hypothyroidism [5%], epilepsy[3.75%]. Utilisation pattern of antiplatelet agents aspirin, clopidogrel were found to be[97.5%] [82.5%] respectively. patients on DAPT[81%] were highest compared to monotherapy [19%]. Patients found with social habits were 38.75% smokers, 31.25% alcoholics and 22% both alcohol and smoking. Conclusion: The present study concludes that DAPT [aspirin+clopidogrel] was found to be superior to monotherapy, and incidence of IHD which is more common in males compared to females. Patients in the group 51-70 were most affected with stroke, IHD and with female predominance over male. Antiplatelet therapy which is clearly efficacious in reducing the incidence of ischemic events/ thromboembolic events DAPT[aspirin+ clopidogrel] was most effective and reduced ischemic events, yet have the risk of bleeding or resistance. Newer anti platelet agents such a Prasugrel and Ticagrelor can be utilised considering the bleeding risk.

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