Evaluation of Post-Surgical Antibiotic Utility Patterns in an Indian Tertiary Care Teaching Hospital

2017 ◽  
Vol 10 (5) ◽  
pp. 3853-3857
Author(s):  
Azad Moidul Islam ◽  
Ankit Acharya ◽  
Satish Kumar B P ◽  
Faruk Azad Kibria ◽  
Renukaa Aradhya Chitti ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Care Hospital ◽  
Rational Use ◽  
Breast Infection ◽  
Dose Combination ◽  
Surgery Department

Rationale use of antibiotic prophylaxis is essential to reduce the incidence of surgical site infections and cost inefficiency. However, inappropriateness of antibiotic prophylaxis administration is still commonly observed in surgical hospitals. A prospective and observational study was carried out in 111 patients at tertiary care hospital in India. Among the 111 study population enrolled in the study, the majority of study populations were males 70.270% and the females were about 29.729%. Among the 111 study populations enrolled in the study, the majority of the subjects belonged to the age group ≥18 years (88%) and followed by 13-17 years (7%) and 1-12 years (4%). Among 111 patients included in the study, the majority of patients were found ulcer (18%) and followed by hernia (12%), appendicitis (9.9%), head injury (4.5%), burn (3.6%), abscess (3.6%), cystitis (2.7%), hemorrhoids (2.7%), cholelithiasis (2.7%), cancer (3.6%), breast infection (1.81%), miscellaneous (4.5%). Among 111 subjects enrolled in the study, the majority of the subjects (74) had surgery (66%) and 37 subjects did not get surgery (33.33%). Among 111 subjects included in the study, the majority of subjects stayed (5-10days) in the hospital for 11 to 31 days. In 78 (70%) cases, there was no drug interaction and only 33 (30%) subjects showed drug interactions at mild to moderate level. In 66 subjects, antibiotics were prescribed in fixed dose combination. In 45 subjects, antibiotic were prescribed by generic name and 35 subjects got antibiotics from both fixed dose combination and generic version. Within 111 subjects, majority of subjects got rational use of antibiotics (85 subjects, 76%) and irrational use of antibiotic found in 26 subjects (23%). This study confirms that the use of antibiotic prophylaxis needs to be continuously focused in surgery department in order to improve rational use of antibiotic prophylaxis to decrease morbidity and cost. 

scholarly journals Knowledge, attitude and prescriptional practice about fixed dose combinations among medical practitioners in tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 1937
Author(s):  
Aravind Ravichandran ◽  
Jayapriya Balamurugan ◽  
. Shankareshwari ◽  
Ramalingam Sekar
Keyword(s):  
Financial Burden ◽  
Tertiary Care ◽  
Text Messages ◽  
Fixed Dose Combination ◽  
Basic Knowledge ◽  
Fixed Dose ◽  
Common Source ◽  
Care Hospital ◽  
Dose Combination ◽  
Study Participants

Background: Fixed dose combination (FDC) are currently most prescribed and misused drug forms. Although fixed dose combinations are clinically better than single dosage forms, improper prescription and large amounts of irrational FDC flooding leads to unwanted financial burden and increased resistance. Therefore a study was carried out to know about the existing scenario about Knowledge Attitude and Practice of Fixed dose combinations among the resident doctors and devise some suggestions for improving the rationality. The objective of the study was to evaluate the knowledge, attitude and prescriptional practice regarding fixed dose combinations among resident doctors working in a Government Theni medical college, Theni.Methods: A cross-sectional descriptive study involving 100 resident doctors was conducted using a pre validated questionnaire containing 21 questions to evaluate the knowledge and prescriptional practice of Fixed Dose Combination among the study participants.Results: Ninety-five percent of the study participants were aware of the Fixed dose combination. Increased compliance and synergistic drug effect are the commonly cited advantages, whereas difficulty in dose adjustment and increased side effects were the commonly told disadvantages. Only 13% of the participants could name a single banned drug. Antibiotics (63%), NSAIDS (18%) were the commonly prescribed FDCs among study participants. Internet (58%), followed by textbook (42%) and colleagues (37%) were the common sources of knowledge about FDCs. Increasing awareness about Essential Medicines List (63%), regular CME (55%) and prior notification (50%) are some of the measures recommended by study participants to improve the awareness.Conclusions: Although the participants are aware of basic knowledge of fixed dose combinations are acceptable, prescribing FDC them often, many of the study participants lack knowledge about the rationality of these drugs. From our study, conducting regular CME’s about new Fixed dose combinations in the medical colleges and periodic notification of FDC’s are some of the suggested approaches to improve the rationality of prescription. Since Internet is listed as the most common source of knowledge about FDC, information about FDC can be sent through mails, text messages, which will play a part in improving the rationality of FDC.

scholarly journals EVALUATION OF RATIONAL USE OF ANTIBIOTIC DRUGS IN SURGERY DEPARTMENT AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 145-149
Author(s):  
SREEJA NYAYAKAR ◽  
MANDARA MS ◽  
HEMALATHA M ◽  
LALLAWMAWMI ◽  
MOHAMMED SALAHUDDIN ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Rational Use ◽  
Post Surgery ◽  
Antibiotic Drugs ◽  
Before And After ◽  
Hospital Patients ◽  
Surgery Department

Objective: Antibiotics are the only drug where use in one patient can impact the effectiveness in another, so antibiotic misuse adversely impacts the patients and society. Improving antibiotic use improves patient outcomes and saves money. Antibiotic resistance has been identified as a major threat by the WHO due to the lack of development of new antibiotics and the increasing infections caused by multidrug resistance pathogens became untreatable. Methods: A prospective observational study was conducted for a period of 6 months. Data were collected from prescriptions and inpatient record files at the surgery department of the tertiary care hospital. Patients above age of 18 years of either gender whose prescription containing the antibiotics and patients who are willing to participate in the study were included in the study. Microsoft Excel was used for recording and analyzing the data of recruited subjects. Results: During our study period, we have collected 100 cases as per inclusion criteria, in total collected 100 cases, 52% are male and 48% are female. The mean age and standard deviation of the study population were found to be 46.61±16.12. The most commonly prescribed classification before and after the surgery is cephalosporin’s that is 57%. Results show that in pre-surgery, almost 93% of prescriptions have chosen the drugs as per ASHP guidelines, whereas in post-surgery, 95% of drugs have selected the drug as per ASHP guidelines. Conclusion: Our study has observed that some of the prescriptions are irrationally prescribed so the pharmacist has to take the responsibility to improve the awareness regarding rational prescribing of antibiotics. The national wide monitoring of antibiotics use, national schemes to obtain rational use of antibiotics, reassessing the prescriptions, education to practitioners, and surveys on antibiotics should be implemented.

scholarly journals EFFECTIVENESS AND SAFETY ASSESSMENT OF FIXED DOSE COMBINATION OF NON-STEROIDAL ANTIINFLAMMATORY DRUGS PRESCRIBED FOR ORTHOPEDIC PATIENTS

2019 ◽  
pp. 70-73
Author(s):  
NILAY SOLANKI ◽  
ALPA GOR ◽  
BIRAJ PARMAR
Keyword(s):  
Adverse Effects ◽  
Tertiary Care ◽  
The Other ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Antiinflammatory Drugs ◽  
Dose Combination ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Orthopedic Patients

Objective: Many Fix Dose Combinations (FDCs) being introduced in India are usually irrational. The most pressing concern with irrational FDCs is that they expose patients to unnecessary risk of adverse drug reactions, for instance, pediatric formulations of nimesulide+paracetamol. Despite their wide clinical use, their gastro-intestinal toxicity is a major limitation. The aim of the present work was to evaluate the efficacy and safety of FDCs in non-steroidal anti-inflammatory drugs in the orthopedic department at a tertiary care teaching hospital. To study the effectiveness and safety parameters of fixed-dose combinations of Non-Steroidal Anti-inflammatory Drugs. Methods: This prospective, observational study was conducted among 150 out-patients of the orthopedic ward over a period of July 2013 to December 2013(Each combination with 50 patients). Three fixed-dose combinations utilized were paracetamol+diclofenac, paracetamol+ibuprofen and paracetamol+nimesulide. The effectiveness was analyzed by using Visual Analogue Scale (VAS) and Disease Activity Scale (DAS) and the safety criteria were analyzed by using the WHO probability scale and Naranjo scale. 150 orthopedic patients attending Out Patient Department were included. 50 participants for each of the combinations of fixed-dose combination (FDCs) of NSAIDs. Results: Out of 150 patients 33 patients developed adverse effects, and 17(51.51%) adverse effects due to the combination of Paracetmol+Nimuselide, 11(33.34%) adverse effects due to the Paracetamol+Ibuprofen and 5 (15.15%) were due to the combination of Paracetamol+Diclofenac. The maximum effectiveness (3.55±0.208) showed in the combination of paracetamol+diclofenac compared to the other two combinations. Conclusion: It was concluded from this study that the effectiveness and safety profile of PCM+DICLO is better than the other two FDCs.

scholarly journals TO STUDY THE DRUG USE PATTERN IN PRIMARY OPEN ANGLE GLAUCOMA IN A TERTIARY CARE TEACHING

2017 ◽  
Vol 10 (2) ◽  
pp. 198
Author(s):  
Deepalatha C ◽  
Leela Pratyusha Mb
Keyword(s):  
Drug Use ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Open Angle ◽  
Duration Of Treatment ◽  
Care Teaching ◽  
Dose Combination

Objective: To study the drug utilization pattern in patients suffering from primary open-angle glaucoma (POAG) in a tertiary care teaching hospital.Methods: It is a prospective study done on 50 patients of POAG (comprising of individuals belonging to any age group). This study was carried for a period of 2-month, and the data included patient’s demographic details and the drugs prescribed. Data were analyzed for drug use pattern.Results: After screening the prescriptions of patients, it was found out that out of total 50 prescriptions, 30 were males, and 20 were females. Out of50 prescriptions, prostaglandins (58%) were most commonly prescribed. β-blockers (16%) were also prescribed. Fixed dose combination constituted60% of the prescriptions. Instructions about the route, frequency, and duration of treatment were present in all prescriptions. Drugs prescribed by their generic names were 18.75% and about 81.25% of the drugs were prescribed by their brand names.Conclusions: Fixed drug combination of timolol and dorzolamide was the most frequently prescribed combination. Prescribers must be aware ofimportance of prescribing drugs with generic names.Keywords: Primary open-angle glaucoma, Intraocular pressure, Fixed dose combination.

scholarly journals Knowledge, attitude, practice of rational use of medicines among junior residents in a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 2001
Author(s):  
Hooli Tanuja V. ◽  
. Srikanth ◽  
Somashekara S. C. ◽  
Suraj B.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
Fixed Dose ◽  
Care Hospital ◽  
Rational Use ◽  
Attitude And Practice ◽  
Junior Residents ◽  
Knowledge Attitude And Practice

Background: Irrational use of prescribing is on the rise due to many factors like false beliefs, following a prescribing pattern of senior doctors, inadequate knowledge, ignorance, promotional activities for the profit of professionals by pharmaceutical industry and lack of enforcement of regulations by regulatory authorities. Junior residents are exposed to variety of prescribing patterns in the first year and are the future physicians and specialists. There are very few studies among JRs, hence the present study was conducted to assess the knowledge, attitude and practice of junior residents about rational use of medicines.Methods: This was a cross-sectional, questionnaire based study conducted among JRs at a tertiary care hospital in South India in June 2015. The participants were explained about the study and consent was taken. Permission was obtained from institutional ethics committee. Identity of the residents was kept confidential. A self-developed, pre-validated, semi-structured questionnaire consisting of both open-ended and closed-ended items was used. Questionnaire was designed to obtain information about the knowledge, attitude and practice of RUM. The data was recorded and analyzed using Microsoft Excel (2013 version) and the results are explained in frequency and percentage.Results: The knowledge related to essential medicines list (EML), P drugs and schedule H drugs was limited. Participants had limited knowledge about the revision of EML list, number of fixed dose combinations (FDCs)in EML, STEP criteria for choosing a P drug and advantages of choosing a P drug Most of the JRs frequently prescribed drugs from EML. Trade name and newer drugs were prescribed around 50%. The prescription of FDCs from EML was very low (6%). Around 50% of JRs prescribe medicines with both generic and brand name.Conclusions: Majority of JRs were aware about various issues concerned with RUM but the knowledge related to EML, P drugs, schedule H drugs and number of FDCs in EML was limited.  As junior residents are future prescribers, they need to be aware of all the aspects of RUM. Inadequate/improper knowledge in the above areas is a matter of concern and needs to be addressed.

scholarly journals A drug utilization study in glaucoma patients in ophthalmology out patient department in a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 1955
Author(s):  
Kaushal B. Patel ◽  
Gurusharan H. Dumra ◽  
Adarsh Jeet Singh ◽  
Abhishek Vyas ◽  
Chetan G. Parmar
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Common Variant ◽  
Fixed Dose Combination ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Open Angle ◽  
Dose Combination ◽  
Patient Department

Background: According to World Health Organization (WHO) studies Glaucoma is a chronic progressive symptomatic disease that damages retinal cells and is one of the leading cause of preventable blindness worldwide. Availability of newer topical agents has modernized the management of glaucoma.Methods: A prospective observational study was carried out from August 2016 to December 2016 at ophthalmology Out Patient Department of L.G General Hospital, Ahmedabad by authours after the approval of the Institutional Ethics Committee.Results: Out of total 101 patients, 71 were males and 30 were females. Average age of patient is 54 years. Common variant of Glaucoma was Primary Open Angle Glaucoma in 57.4% of patients. Average number of drugs per prescription was 2 (45%). Most commonly used Fixed Dose Combination was Brimonidine +Timolol Drops which was used in 87 (86.1%) patients. Most commonly used adjuvant drug was Tab. Acetazolamide (60% of patients).Conclusions: Common variant of Glaucoma was Primary Open Angle Glaucoma in 57.4% of patients. Most commonly used Fixed Dose Combination was Brimonidine+Timolol Drops which was used in 87 (86.1%) patients and commonly used Single drug therapy is Tab. Acetazolamide in (60% of patients).

scholarly journals Assessment of rational use of fixed dose combinations in hypertension in a tertiary care teaching hospital in north India

2018 ◽  
Vol 5 (5) ◽  
pp. 1263 ◽  
Author(s):  
Rohini Gupta ◽  
Apoorva Malhotra ◽  
Pavan Malhotra
Keyword(s):  
Tertiary Care ◽  
Drug Combinations ◽  
North India ◽  
Fixed Dose ◽  
Cross Sectional ◽  
Jammu And Kashmir ◽  
Rational Use ◽  
Dose Combination ◽  
Come Into The Market ◽  
Dual Drug

Background: Fixed-dose combination (FDC) agents could be considered as an effective therapy in chronic illnesses like hypertension, which have multifactorial etiology. At present, many FDCs have come into the market without being assessed for their efficacy, safety and rationality by the drug regulatory authorities. The objective of the present study was to assess the rational use of fixed dose drug combinations in hypertension.Methods: It was a cross-sectional observational study conducted in the cardiology outpatient department of ASCOMS and H, Sidhra, Jammu, Jammu and Kashmir from February 2016 to July 2016. In the study 92 prescriptions of hypertensive patients who were on anti-hypertensive fixed-dose drug combinations (FDCs) were recruited after thoroughly evaluated for inclusion and exclusion criteria. Data obtained includes the demographic profile of the patients, pattern of the prescribed FDCs in hypertension, evaluation of the rationality of the FDCs based upon the comprehensive seven-point criteria developed by Panda et al.Results: In the present study, about sixteen different anti-hypertensive FDCs were observed in the prescriptions of 92 patients during six-month period. It was observed that about 93.75% of FDCs were dual drug combinations. Among the dual drug combinations, most commonly used combination was Olmesartan (ARB; Angiotensin receptor blocker) + Amlodipinine (Calcium channel blocker) in 17.4% of patients. It was also observed that among the 16 different anti-hypertensive fixed dose combinations analysed, 12 FDCs (75%) were found to be rational and 4 FDCs (25%) were found to be irrational.Conclusions: In the present study it was found that 75% of the FDCs prescribed were rational and 25% were irrational. Therefore, before marketing the FDCs proper assessment of their efficacy, safety and rationality should be done.

scholarly journals PRESCRIBING PATTERN OF ANTIBIOTICS AMONG OUTDOOR PATIENTS IN MEDICINE DEPARTMENT OF TERTIARY CARE HOSPITAL IN NORTHERN INDIA

2020 ◽  
pp. 43-46
Author(s):  
SUMAN LATA ◽  
VIJAY KHAJURIA ◽  
VINEETA SAWHNEY ◽  
SANJAY SHAH
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Fixed Dose ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Medicine Department ◽  
Medical College ◽  
Northern India ◽  
Dose Combination

Objective: The objective of the present study was to examine the prescribing pattern of antibiotics in the outpatient department of medicine in a tertiary care hospital. Methods: This prospective observational study was conducted in department of pharmacology in collaboration with department of medicine of Govt Medical College Kathua for a period of one month. Prescription of all patients attending medicine OPD who were prescribed antibiotics was analysed. Results: A total of 450 prescription of OPD patients were analysed. Out of these 200 prescriptions of patients had antibiotics prescribed. 98% of prescriptions had oral antibiotics and other 2% were prescribed injectable antibiotics. 70 % of prescriptions were on the single antibiotic and in 30% of prescriptions, fixed-dose combination were prescribed. Cefpodoxime antibiotic was most commonly prescribed in the cephalosporin group, followed by amoxy-clavulanic acid, azithromycin. Irrational prescribing of antibiotics was 34% and it was quite high in our study. Conclusions: Cefpodoxime was most commonly prescribed in cephalosporin group among all antibiotics. Irrational prescribing was quite high in present study. Our result calls for the urgency of refresher courses like stewardship programmes regarding antibiotic use to avoid irrational usage.

scholarly journals Knowledge, attitude and practice regarding use of fixed dose combination drugs among young prescribers a tertiary care teaching hospital in rural Bengal, India

2019 ◽  
Vol 8 (7) ◽  
pp. 1479
Author(s):  
Ananya Mandal ◽  
Sonai Mandal ◽  
Somenath Das
Keyword(s):  
Patient Compliance ◽  
Synergistic Effects ◽  
Tertiary Care ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Cross Sectional ◽  
Medical College ◽  
Prescribing Practice ◽  
Dose Combination ◽  
Graduate Trainees

Background: Use of fixed dose combination (FDCs) is a double edged sword with scope for irrational prescribing on one hand and improved pharmacotherapy and patient compliance on the other hand. Irrational FDCs are being marketed aggressively and often young prescribers including Post Graduate Trainees fall prey to the lure of FDCs. This was a Knowledge-Attitude-Practice study regarding of FDC use among the resident doctors working at a tertiary care medical college of rural Bengal.Methods: This was a cross-sectional, questionnaire based study including 50 resident doctors who were asked to fill a 10-question questionnaire on FDCs anonymously.Results: Ninety two percent of the study participants were aware of the FDCs. The most commonly perceived advantages were better patient compliance and synergistic effects. Most (96%) cited problems of titrating dosages and problems of more side effects. Only 37.6% knew about the banned FDCs. Preferred FDCs among them were antibiotics (94%), cough syrups (80%) and NSAIDs (68%). Residents of dermatology, orthopaedics, surgery and medicine most commonly prescribed FDCs. Sources of knowledge regarding FDCs were CME (92%), medical representative (76%), colleagues (72%), internet (68%), journals (48%) and textbooks (36%).Conclusions: The study showed that most participants were aware of the FDCs and also aware of the problems with irrational FDC use. Knowledge regarding banned drugs was poor as was the rationality of such combinations. More CMEs and inter department group discussions could be conducted to improve awareness and FDC prescribing practice among young prescribers.

scholarly journals RATIONALITY ASSESSMENT OF ZINC FORMULATIONS AVAILABLE IN INDIA

2017 ◽  
Vol 9 (8) ◽  
pp. 200
Author(s):  
Krishnan Vengadaragava Chary ◽  
Rithu Bhaskaran
Keyword(s):  
Tertiary Care ◽  
Daily Intake ◽  
Essential Medicine ◽  
Fixed Dose ◽  
Care Hospital ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Study Results ◽  
Dose Combination ◽  
Sectional Analysis

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.

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