scholarly journals Prescribing pattern and utilization of selected antimicrobials in a tertiary hospital of Nepal

2019 ◽  
Vol 1 (2) ◽  
pp. 96-102
Author(s):  
Upasana Acharya ◽  
Ravi Mahat ◽  
Subhash Prasad Acharya ◽  
Bishnu Pahari ◽  
Prashant Tripathi
Keyword(s):  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Empiric Treatment ◽  
Bed Days ◽  
One Year ◽  
Increasing Trends

 Introduction: This study was done to understand the purpose of using higher grade antimicrobials in a one year period and to compare the consumption of commonly prescribed parenteral antimicrobial agents in four consecutive years in a tertiary care hospital of Nepal. Materials & Methods: A retrospective observational study was carried out to collect the information on prescription of selected six classes of antimicrobial for all admitted patients aged 2 years or above for a one-year period. Further, the antimicrobial consumption tool 2016 was used to calculate defined daily dose (DDD) per 100 bed days of commonly dispensed parenteral antimicrobials for four consecutive years. Results: A total of 2568 antimicrobial supply forms prescribing higher grades antimicrobials were analyzed. The indications for use of antimicrobials were mainly for empiric treatment. Among the infections being treated, lower respiratory tract infection (LRTI) was the most frequent cause. Piperacillin-tazobactam was most frequently prescribed followed by Meropenem. Also, DDD for commonly used parenteral antimicrobials showed increasing trends over four consecutive years. Conclusion: The prescription of higher grades of antimicrobial for empiric treatment and surgical prophylaxis need to be monitored. The rate of consumption of such antimicrobials could not be assessed due to lack of similar studies but the increase in DDD/100 bed days each year suggested the rise in consumption of antimicrobial in the same institution.

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.

scholarly journals Achromobacter: an emerging nosocomial pathogen

2019 ◽  
Vol 7 (8) ◽  
pp. 3090
Author(s):  
Kxitiza Pandey ◽  
Sulekha Nautiyal
Keyword(s):  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Antibiotic Sensitivity ◽  
Opportunistic Pathogen ◽  
Achromobacter Xylosoxidans ◽  
Care Hospital ◽  
Aerobic Culture ◽  
Automated Method ◽  
One Year

Background: Achromobacter is a ubiquitous, non-fermenting, Gram-negative bacterium that lives in soil and aquatic environments. In recent years, many studies have shown its potential as opportunistic pathogen. It can colonize various items used in hospital and can survive various disinfectants. The infections get complicated due to its vast spectrum of intrinsic and extrinsic resistance to antimicrobial agents and disinfectants. Achromobacter spp. is an emerging pathogen and is becoming a reservoir for horizontal genetic transfer elements involved in spreading antibiotic resistance. This study was conducted to assess the extent of the Achromobacter related infection in our hospital setting and to set a baseline for future studies.Methods: This study was conducted over a period of one year (January to December 2018) in our tertiary care hospital. All specimens submitted for aerobic culture and sensitivity were analyzed and the bacterial identification and antibiotic sensitivity of the isolates was carried out using automated method (Vitek 2 Compact, bioMerieux).Results: Achromobacter species was reported from 0.46% (63/13831) specimens, 40% of them were isolated from suction tips. Achromobacter denitrificans amounted for 47/63 (74.6%) while Achromobacter xylosoxidans was identified in 16/63 (25.4%).Conclusions: Studying the organisms in order to observe their changing trends

scholarly journals Antimicrobial prescribing pattern in a tertiary care teaching hospital: a pilot study

2020 ◽  
Vol 9 (3) ◽  
pp. 465
Author(s):  
Bhagyashri D. Rajopadhye ◽  
Sonali H. Palkar ◽  
Vijaya A. Pandit ◽  
Priti P. Dhande ◽  
Mahadevan Kumar ◽  
...  
Keyword(s):  
Pilot Study ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Current State ◽  
Stewardship Program ◽  
Tract Infections ◽  
Emergence Of Resistance

Background: The emergence of antimicrobial resistance is a worldwide challenge threatening to negate the gains made by discovery of antimicrobial agents (AMAs).  Antimicrobial Stewardship Program (ASP) is an important strategy for ensuring appropriate use of AMAs and controlling emergence of antibiotic resistance. Implementation of ASP must start with assessment of the current state of antimicrobial use. This study was therefore conducted to assess the prevalent prescribing patterns in a tertiary care hospital and identify gaps which warrant corrective intervention.Methods: This prospective pilot study presents analysis of the first 30 Patients from the medicine ward prescribed at least one antimicrobial agent during the two months of study period. Relevant data was collected in AMA record form. Appropriateness of AMAs was analyzed regarding selection as well as administration protocol as per the hospital antibiotic policy.Results: Out of the 60 AMAs prescribed to these patients, most commonly prescribed were cephalosporins (63.3%), anti-amoebics (26.6%) and macrolides (23.3%). Common diseases involved were urinary tract infection, acute gastroenteritis, sepsis and lower respiratory tract infections.  Use of AMAs was found to be appropriate for the indication in 42 %, dose in 97%, duration 60 %, route 93% and frequency 90 %.Conclusions: This gap between the appropriate and the actual practice use of AMAs indicates an urgent need of rigorous implementation of ASP in order to avoid emergence of resistance and to conserve the sensitivity to the available AMAs.

scholarly journals Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India

2019 ◽  
Vol 8 (9) ◽  
pp. 1951
Author(s):  
Rajendra Kumar Panda ◽  
P. Ansuman Abhisek ◽  
Lalit Mohan Sika ◽  
Shweta Supriya Pradhan ◽  
Sidharth Srabana Routray ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Agents ◽  
Multinomial Logistic Regression ◽  
Tertiary Care ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Defined Daily Dose ◽  
Female Ratio ◽  
Utilisation Pattern ◽  
Bed Days

Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.

scholarly journals A study on antimicrobial agents utilization pattern using anatomical therapeutic chemical / daily defined dose system and adverse drug reaction pattern in the intensive care unit of a tertiary care teaching hospital in North Eastern state of India

2018 ◽  
Vol 7 (8) ◽  
pp. 1612 ◽  
Author(s):  
Debasis Ray ◽  
Smita Datta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Revolutionary Change ◽  
Prescribing Pattern ◽  
Therapeutic Benefits

Background: Successful use of antibiotics has brought a revolutionary change in the management of infectious diseases but has also resulted in its irrational use. Indiscriminate use of anti-microbial agents (AMAs) has been well-documented in the ICUs where polypharmacy is a common phenomenon, thus increasing the risk of Adverse Drug Reactions (ADRs). It is extremely imperative to evaluate the prescribing pattern of antimicrobials for enabling suitable modifications in prescribing patterns; to increase the therapeutic benefits and for optimizing the health care services.Methods: With the objective to assess the prescription patterns of AMAs and the rationality of their use this observational study was undertaken in the Intensive Care Unit of a Tertiary Care Hospital for two months.Results: Of the total 127 patients, 80 (62.99%) were male and 47 (37.01%) were female at an average age of 51.3±18.3 years. 102 (80.31%) patients received AMAs at average of 1.71±0.99 and 25 (19.69%) didn’t. Betalactam antibiotics were the most frequently (72.99 %) prescribed class. Meropenem was the most commonly prescribed (41 occasions) agent. The length of stay in ICU per patient was 4.42±3.49 days. 41.63% patients had more than two morbidities. No AMAs were prescribed in generic name. In 28 (27.45%) patients the AMAs prescribing were irrational.Conclusions: The high utilization rates of costly AMAs and irrational prescriptions are matters of great concern and need to be urgently addressed by use of guidelines, surveillance and antibiotic restriction policies and sensitization programs at all level of healthcare.

scholarly journals STUDY OF PRESCRIBING PATTERN OF ANTIMICROBIAL AGENTS IN MEDICINE INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 136-140
Author(s):  
DUDHE BG ◽  
CHAKRAVORTY ASHISH D ◽  
MANKAR NN ◽  
PISE HN
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Generic Drugs ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Case Record ◽  
Treatment Data

Objective: The objective of the study was to assess the current use of antimicrobial agents (AMAs) and to assess prescription writing as per the WHO guidelines in the medicine intensive care unit (MICU). Methods: The present study was conducted on admitted patients in MICU of a tertiary care hospital. The demographic and clinical treatment data of patients were collected in specially designed pro forma from the case record form. Results: Of 400 patients enrolled in the study, 55.50% were male and 44.50% were female. A common indication of AMAs use was infection (61.75%), symptomatic (21.50%), and prophylactic (10.50%) use. In 65% patients, antimicrobial therapy was considered to be rational. The majority of patients have good recovery (61%). Polypharmacy was seen in 89.75% of patients. The average number of drugs prescribed per patient was 8.84±2.55. 1.90±1.20 was average number of AMAs per patient. Commonest AMAs prescribed are ceftriaxone (27.64%), metronidazole, and amoxicillin+clavulanic acid. Conclusion: This study visibly highlights the practice of polypharmacy, low uses of generic drugs, high usage of antibiotic, and injection. Cephalosporins are the most prescribed AMAs in the ICUs. Remedy of this situation requires regulation, education, awareness, compliance with protocol, and guidelines of AMAs use.

scholarly journals A Prospective Study on Usage Pattern of Corticosteroids in a Tertiary Care Hospital

2019 ◽  
Vol 11 (05) ◽  
Author(s):  
V. V. Rajesham ◽  
Ch. Swethasri ◽  
E. Mamatha ◽  
Keerti Tiwari ◽  
P. Pooja Raj
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
General Medicine ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Usage Pattern ◽  
Prescribing Pattern ◽  
Dermatology Department ◽  
Daily Dose ◽  
A Prospective Study

Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history,drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.

scholarly journals Use of the Maternal Foetal Triage Index: Addressing the Third Delay in Obstetrics

2021 ◽  
Author(s):  
Nirzarini Mukul Vora ◽  
Nandita Krishnakant Maitra
Keyword(s):  
Tertiary Care ◽  
Vital Signs ◽  
High Volume ◽  
Tertiary Hospital ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Convenience Sample ◽  
The Third ◽  
Maternal And Neonatal Outcomes ◽  
One Year

Abstract PURPOSE: While several scales have been developed specifically for obstetric triage, the Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated for women attending the triage area of a tertiary hospital. This study intends to evaluate the effect of MFTI score on third delay and maternal and neonatal outcomes.METHODS: A prospective observational study was conducted over a convenience sample of 1000 subjects who attended the Labour and Delivery Unit of a tertiary care hospital over a period of one year. Assessment included maternal history, baseline vital signs and obstetric examination. The woman was categorised as per the MFTI scale and directed to the appropriate area for further management. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance.RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean section, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 (p<0.0001). The average time spent in the triage room was 30±17minutes. Maternal and neonatal outcomes were analysed according to priority based on OBICU admissions, mortality, NICU admissions and stillbirths and found to be significant.CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low-resource emergency obstetric setting. This also simplified handover of subjects, improved documentation and decreased time to secondary healthcare provider assessment.

scholarly journals Antibiotic prescribing pattern among paediatric patients attending tertiary care hospital in South India

2020 ◽  
Vol 9 (7) ◽  
pp. 1028
Author(s):  
R. P. Priyadharsini ◽  
R. Kesavan
Keyword(s):  
Health Care ◽  
Generic Drugs ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Age Group ◽  
Prescribing Pattern ◽  
Essential Drug List ◽  
Paediatric Age

Background: The usage of antibiotics among paediatric age group in India is on the higher side, that more than 60% of children in the age group 0 to 4 years received antibiotics. The higher use of antibiotics results in antibiotic resistance, increased health care costs, adverse drug reaction and may complicate the treatment of infections in future. There is a continuous need to monitor the prescription of antibiotics at all health care levels to prevent antibiotic resistance.Methods: A prospective and descriptive study was conducted in one of the pharmacies which dispenses the paediatric prescriptions in a tertiary hospital. The prescriptions used to treat infection were collected and analysed. A total of 500 prescriptions were collected and analysed.Results: The prescriptions were analysed for the WHO prescribing indicators. The average number of drugs per prescription is 1.84 with 21% of the prescriptions containing antibiotics. The most commonly prescribed antibiotics were penicillin like amoxycillin, phenoxymethyl penicillin followed by cotrimoxazole and cephalosporin group of antibiotics. The antibiotics prescribed belonged to the access group of antibiotics. The percentage of the prescriptions with drugs form essential drugs list and prescribed with generic name is 65.8% and 67% respectively. There were no injections prescribed.Conclusions: The antibiotic prescribing pattern and the average drugs per prescription falls with the WHO range indicating reduced use of antibiotics and absence of polypharmacy. However, the prescription of generic drugs and the drugs from the essential drug list is less.

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