scholarly journals Antibiotic Prescription Pattern Among The In-Patients Of A Tertiary Care Hospital

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 132-136
Author(s):  
Raj shivaani M R ◽  
Preetha Selva

Antibiotics happen to be the most commonly used medicines, especially in developing countries like India, where infectious diseases are at a raise. Millions of antibiotics are prescribed by physicians all over India. The main objective of the present study is to analyze the prescription pattern of the antibiotics given to the in-patients of our hospital and to access the rationality of these prescriptions given, using the World Health Organization's core drug prescribing indicators. A total of 400 in- patients from Departments of Pediatrics, General Surgery, Obstetrics & Gynecology and Orthopedics were analyzed after screening for inclusion and exclusion criteria. The numbers of females are 248 (62%) and the males are 152 (38%) in a ratio of 1:1.63. 101 patients belonged to 40-60 years age group.  The pattern of antibiotic usage in the Department of Pediatrics, Obstetrics and Gynecology, General Surgery, Orthopedics was studied. The most common antibiotics prescribed were Cefotaxime (44%), Amoxicillin(38%) and  Cefazolin (38%, 24%) in Departments of Pediatrics, Obstetrics & Gynecology,  Surgery and Orthopedics respectively.   The total numbers of drugs prescribed were 1441 out of which 612 were antibiotics (43.09%). The number of antibiotics per prescription was 1.53. The average number of drugs prescribed per prescription was 3.6. The percentage of encounters with injections was 26.48%. The percentage of drugs prescribed by generic name is 36.2%. The percentage of drugs from the Essential Drug List was 92%. The percentage of fixed-dose combinations of antibiotics prescribed was 14.54%. Hence, in our study, though most of the drugs are given from the Essential List of Medicines, drugs given by a generic name is low. Physicians can be encouraged to prescribe more drugs by generic name. To conclude, antibiotic stewardship interventions have to be implemented to promote the judicious use of antibiotics to prevent adverse consequences.

Author(s):  
Shantadurga S. Kerkar ◽  
Padma N. Bhandare

Background: Gastrointestinal (GI) diseases are a common problem worldwide. They are frequently encountered in non-critical as well as in critically ill hospitalized patients.Methods: This was a prospective and observational study conducted on patients admitted in CCU and ICCU of Goa Medical College and Hospital. Data was collected from the patients’ case records and was analysed referring to WHO prescribing indicators. Data was represented as Mean±SD, number and frequency.Results: A total of 2250 drugs were prescribed, out of which 376 (16.71%) were gastrointestinal drugs. Most common route of administration was oral 323 (85.90%). Prescription patterns of GI drugs were:  275 (73.14%) from National List of Essential Medicines, 20 (5.31%) as fixed dose combinations and 4 (1.06%) by generic names. Pantoprazole 183 (48.67%) was the most frequently prescribed drug for peptic ulcer in present study.Conclusions: From the findings of this study we noted that among the GI drugs used, those for peptic ulcer were the most commonly prescribed. Also majority were from the essential drug list. But prescribing by generic names was low. Review of drug utilization trends is a necessary aid to formulate and modify existing protocols and guidelines to improve treatment outcomes in a given setting.


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.


2019 ◽  
Vol 7 (7) ◽  
pp. 1203-1208 ◽  
Author(s):  
Asmatanzeem Bepari ◽  
Nayana Sakre ◽  
Ishrat Rahman ◽  
Shaik Kalimulla Niazi ◽  
Asmabi M. Dervesh

BACKGROUND: Cancer is a major burden and threat to global society. A wide range of chemotherapeutic agents is extensively used to treat cancer at different stages. Inappropriate drug use may also lead to the raised cost of medical care, adverse drug effects, and patient mortality. Hence, in recent years, drug utilisation studies have become a potential tool to be used in the evaluation of different health care systems including cancer. AIMS: The objectives of the study were to identify the various types of cancer, the commonly prescribed drugs, rational use of anticancer drugs, and analyse the prescribing indicators in a tertiary care government hospital of India. MATERIAL AND METHODS: Newly diagnosed cancer and/or known case of carcinoma of either sex which required treatment/on treatment with chemotherapy aged > 18 yrs admitted in Radiotherapy Department from April 2016 to September 2016 were included in the study and analysed for prescribing indicators. RESULTS: The head & neck cancers were the prevalent cancers observed with more preponderance among males. Most of the patients were prescribed with a single anticancer drug. Cisplatin was the most commonly used cytotoxic drug followed by carboplatin, and antimetabolites. The most commonly used adjuvant drugs in our study were anti-emetics and anti-peptic ulcer drugs. Over 82% of anticancer agents were taken from the essential drug list and were prescribed in generic names, indicating rational use. CONCLUSION: Over 82% of anticancer agents were taken from the essential drug list and were prescribed in generic names, indicating rational use.


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):  
Sini K. ◽  
Mohammed Basheer ◽  
Shaikh Ubedulla Shaikh Iqbal Daud ◽  
Divya G. Krishnan

Background: Geriatric population due to the age related changes in pharmacokinetics and pharmacodynamics and the presence of comorbidities is vulnerable to drug interactions, adverse effects and high cost of therapy. This necessitates a periodic review of DU pattern in the geriatric population to ensure safe and effective treatment for them. The present study was undertaken to evaluate the DU pattern for medical conditions among the geriatric population in the Orthopaedic outpatient department (OPD) of a tertiary care hospital in Kerala.Methods: In this cross sectional observational study conducted in the Orthopaedics OPD of a tertiary care hospital, prescriptions were collected from patients attending the Orthopaedics OPD randomly over a period of 6 months. Out of these, prescriptions of male and female patients of age more than 60 years were sorted and analysed using World Health Organization drug prescribing indicators as well as additional parameters and the data was presented in the form of frequency and percentages using tables and charts.Results: A total of 800 prescriptions were collected and studied of which 76 (9.5%) belonged to patients from the geriatric population. Majority of the patients were in the age group of 61-70years (52.63%). Spondylosis (42.10%) was the most common indication for patients attending Orthopaedics OPD. Average number of drugs per prescription was 3.05 with a range between 1 and 5. Only 5.17% drugs were prescribed using generic name. Utilization from the essential drug list was 39.65%. The percentage of encounters in which an antibiotic and injection prescribed was 0% and 10.34% respectively. Of the total drugs prescribed 35% were FDCs. The most routinely prescribed drugs among the various classes were NSAIDs 34% followed by gastroprotectives (25%). The assessment of prescriptions with regard to completion and legibility was satisfactory.Conclusions: Current study pointed out deficiencies like polypharmacy, low prescribing of drugs by generic names, low prescribing of drugs from the essential drug list and higher use of FDCs. Use of antibiotics and injections was satisfactory and acceptable. Legibility and completion of prescription format was largely satisfactory. Proper strategies to rectify these deficiencies can ensure safe and effective treatment for geriatric patients.


2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Naresh Karki ◽  
Ruban Raj Joshi ◽  
Buddhi Kumar Shrestha ◽  
Pravin Prasad

Introduction: Drug utilization research is an important tool to facilitate rational use of drugs. In low income countries irrational use of drugs is a common problem like overuse of drugs and inappropriate use of antibiotics, leading to poor treatment outcome and increased burden of treatment. This study was conducted to provide understanding of drug utilization pattern by using WHO Core Prescribing Indicator. Methods: This study was conducted in Orthopedics and Obstetrics / Gynecology departments. Patients visiting these Out Patient Departments with at least one drug on prescription form were included in the study. Further, information related to WHO Core Prescribing Indicators were collected in pre-designed proforma. Results: Average number of drugs prescribed per prescription was 2.6. Means of number of drugs prescribed in Orthopedics and Obstetrics / Gynecology departments were 2.9 and 2.3 respectively (p < 0.001). Drugs prescribed in generic name and from essential drug list was 41.4% and 34.3% respectively. Prescription forms with generic name in Orthopedics department were significantly more compared to Obstetrics / Gynecology department (p = 0.00002). However, there was an increased tendency to prescribe drugs from essential drug list in Obstetrics / Gynecology department compared to Orthopedics department (p < 0.001). Conclusion: Drugs were prescribed by generic name and from essential drug list, but this was not sufficient to meet the ideal values of WHO Core Prescribing Indicator. Therefore, prioritization on prescribing drugs by generic name and from essential drug list by respective departments to achieve the standards of WHO needs to be encouraged.


Author(s):  
DURGA PRASAD THAMMISETTY ◽  
DIVITI RANGANAYAKULU ◽  
DEVANNA NAYAKANTI

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients. Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs. Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p<0.001), polypharmacy (p<0.001), and hospital stay (p<0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%. Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.


Author(s):  
Shobha P. ◽  
Messaline Sunitha

Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.


Author(s):  
Ayan Roy ◽  
Nayan Kumar Patel

Background: Cardiovascular morbidity plays a villainous role globally as well as countries like India. Additionally, irrational prescription incurs greater damage to health and wellbeing. Drug utilization studies scrutinize the appropriateness of treatment and provide favorable feedbacks to strengthen clinical practices. The objective of the study was to describe treatment practices in cardiology outpatient and drug utilization pattern using core prescribing indicators by World Health Organization (WHO).Methods: A cross-sectional, observational study of 4-month duration was undertaken for cardiology Outdoor patients at a tertiary care hospital. 615 prescriptions were screened and analyzed.Results: Males (59.84%) were more in number than females (40.16%). Average number of the prescribed drugs per patient were 4.32±2.7 and (3.73±1.1 for cardiovascular drugs). Generic prescription was 60.98%. Percentage encounters with antibiotics 4.11, injectables 2.92%, fixed-dose combinations (FDCs) (11.8%) were documented. Drugs from the National List of Essential Medicines were 75.89%. The most common diagnosis was ischemic heart disease (68.29%). Hypolipidemics (78.25%) followed by antiplatelets (71.14%) were toppers in cardiovascular drug. Antiulcer drugs (PPI/Antacids) comprised 58.54% of total prescriptions.Conclusions: Less adherence to EDL, less generic prescriptions, use of FDC are major shortcomings. Areas to further rationalization like optimal use of evidence based medication like beta-blockers, newer anticoagulants/anti-platelet agents and newer anti-anginal agents are identified.


Author(s):  
Maddala Rajitha ◽  
Altaf Hussain Shaik ◽  
G. B. Simpson ◽  
A. Vishwa Shanthi

Background: The fixed dose drug combinations (FDCs) of drugs is defined as product of two or more active ingredients in a defined composition. There is a need to study the pattern of prescription from time to time to evaluate their rationality. In this context we undertook this study to know the prescription pattern of FDC in our setting. To study the rationality of different prescribed FDCs.Methods: This is a prospective study which is carried out in NIMRA Institute of medical sciences which is a tertiary care teaching private hospital. For this study we have collected one thousand prescriptions of patients for 3 months that is from 10th March 2017 to 25th of June 2017 including both in-patients as well as outpatients. Selection criteria of patients mainly basing on their willingness to give prescriptions. Institutional ethical committee permission was taken for the study. The prescribed FDCs were compared with the essential drug list of FDCs approved by Drugs Controller General of India, July 2018.  we have used descriptive statistics to analyze data. The percentage of FDCs used in each class and their contribution to overall FDCs were calculated.Results: In a total of 2952 drugs were prescribed, of this 747 were FDCs and 2205 were non FDCs. In the prescribed FDCs 89.2% drugs were rational and 10.8% drugs were irrational.Conclusions: From this study, we can conclude that 10.8% of irrational prescription of fixed dose drug combinations are prescribed in Nimra Institute of Medical Sciences which is a tertiary care teaching private hospital.


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