ABSTRACT
Background: Pediatric diarrhea is the second most common cause of childhood mortality globally. Despite being self-limiting, polypharmacy is rampant in their treatment. The adherence of practitioners to the recommended guidelines can be assessed by drug utilization studies. Aim and Objectives: The aim of the study was to assess the drug utilization pattern of acute diarrhea management in children. Materials and Methods: A prospective observational study was undertaken for 12 months at pediatric inpatient unit of BRIMS, Bidar. Prescriptions of 400 cases of acute diarrhea in children of either gender aged 1?12 years were evaluated for the pattern of drugs prescribing using the WHO core indicators. Results: The study showed male preponderance with 54.75% being males. Every prescription, on an average had five drugs for diarrheal management. About 43.5% prescriptions had at least two antibiotics. Out of a total of 2237 drugs prescribed, 1392 (62.2%) drugs were prescribed as injections. About 78.5% medicines were selected from the National List of Essential Medicines (NLEM), 2015 and 87.12% drugs were from the hospital formulary. Drugs were categorized as per ATC/DDD system using the WHO reference DDDs and ATC codes website. PDD to DDD ratio of majority of drugs was 0.99. Conclusion: We observed polypharmacy in practice for diarrheal illness in our study. Accentuation on evidence-based management and adherence to the treatment guidelines may help in improved and rational drug use in children.
ABSTRACT
Objective:Aim of this study is to assess the drug utilization pattern of cardiovascular drugs in cardiology outpatient department (OPD). Methodology:This prospective, multicenter, cross-sectional observational study was conducted at three selected tertiary care hospitals from different regions in South India. A total of 1026 prescriptions of the patients attending cardiology OPD of these selected hospitals 342 each over a period of 12 months was randomly identified and included in this study then critically analysed for WHO/INRUD core prescribing indicators. Results:Medicines prescribed from NLEM were 89.27%, average drugs prescribed was 5, medicinesprescribed by its generic name were 2.33% and encounters with an injection prescribed were 14.52%. Commonly prescribed different class of drugs for CVDs patients were Anti-platelets (67.73%) followed by Statins (62.57%), Beta blockers (49.51%), ACE-inhibitors (40.93%), Angiotensin receptor blockers (30.40%), Calcium channel blockers (30.11%), Nitrates (25.34%), Diuretics (20.56%), Anticoagulants (20.27%), Vasodilators (9.94%) rest of the cardiovascular drugs were prescribed within 0.5-5% only, other class of drugs also prescribed for patients with different comorbidities are Anti-ulcers (69.10%), Opioid analgesics (4.09%), Antacids (3.80%), Anti-emetics and Pro-kinetics (1.85%), a pattern of poly-pharmacy was clearly evident, majority of drugs were prescribed as single drug (86.78%) whereas 13.21% as FDCs. The most commonly prescribed single drug was Aspirin (59.93%) and FDCs were Aspirin + Clopidogrel (40.24%). Anti-thrombotic agents’ particularly antiplatelet drugs expected to overtake anti-cholesterol drugs as the sales leader in the market. Maximum drugs were prescribed from the recent NLEM of India by most of practitioners its shows its acceptance and implementation by the prescribers.Conclusion: Deprescribing PPIs for the non-required patients is suggested to lower the risk of adverse drug interactions and economic burden to patients, also pharmacists needs to encourage the prescriptions with drugs in generic name if it’s deviated from the standards recommended by WHO/INRUD
ABSTRACT
Background: The therapy of antibiotics among the paediatric patients may produce any type of adverse effects as the organs of infants and children are immature and the genetic constituents are also not fully known. The empirical use of antibiotic may also produce antibiotic resistance. Aim was to study the prescribing pattern of antibiotics among the paediatric patients.Methods: It was a retrospective, observational study for a period of six months. The collected data included age, sex, diagnosis and line of management. Generic name and average cost of treatment per patient was evaluated by using CIMS 2019 and Bhartiya Jan Aushadhi Pariyojna. The descriptive statistics was applied for the detail data analysis.Results: Bed head tickets (BHTs) of 560 inpatients was examined. The common diagnosis were AGE (193; 34.4%) and ARI (60; 10.7%). The route of administration were oral 279 (49.8%) and parenteral 281 (50.1%). The duration of hospital stay were in between 5 days (141; 25.1%) to 7 days (61; 10.8%). The minimum and maximum age of the patient were 3 months and 12 years respectively. The most common antibiotic used was ceftriaxone and metronidazole. The number of patient received single antibiotic was 295 (52.6%) and multiple used was 265 (47.3%). The number of antibiotic prescribed from NLEM and Pariyojna were 9 and 13 respectively. The average cost of treatment per patient was Rs. 345.00 (CIMS) and Rs. 119.90 (Pariyojna) approximately.Conclusions: The antibiotics prescribed by generic name was not satisfactory. The proposal for wide awareness programme may be suggested to the concerned authority for improving the prescribing practice among the physicians at different levels.
ABSTRACT
The concept of essential medicines was introduced in 1977 with the publication of the World Health Organization's (WHO) Model List of Essential Medicines. These medicines are intended to satisfy the priority health care needs of the population. They are selected with regard to public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness. Essential medicines are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and at a price the individual and the community can afford. The WHO advises countries to adapt the essential medicines list according to their priority health care needs. The model list of WHO serves as a guide for the development of a national list of essential medicines (NLEM). An essential medicines list can serve as a model for procurement, local licensing and manufacturing, and the rational use of good-quality medicines, especially within the public sector. It also helps in allocating limited resources effectively and in a cost-effective manner.