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Background: Use of antibiotics in special population like children is not same as adult. Pediatric age group will have difference in pharmacokinetics, pharmacodynamics, efficacy, and safety of drugs. In children, the maturity of major organs will be in developing stage which would affect the absorption, metabolism, distribution, and excretion of drugs. Hence, irrational prescription of drugs may lead to many adverse effects ranging from mild to severe. In developing countries like India, we do not have much unbiased information on the currently used drugs. Hence, the current study focused on antibiotic use among pediatric population using data from a tertiary care teaching hospital. Aim and Objectives: The objectives of the study were as follows: (i) To observe antibiotic prescription trends in in-patients of pediatric ward and (ii) to analyze rationality of antibiotic prescription. Materials and Methods: It is a prospective observational study which was conducted over a period of 1 year. Institutional Ethics Committee approval was taken before conducting the study. The data of inpatients of pediatric ward were collected in a separate well-designed preform. Inpatients with age group of 0–14 years were included in the study. Results: Out of 1050 patients, 471 were below the age group of 1 year, 220 patients were between 1 and 5 years, and 359 patients were above the age of 5 years. The percentage of patients with antibiotic prescribed was 92.1%. Respiratory tract infections were predominantly seen among children, especially bronchopneumonia was seen in 6.6% of the patients. Among the antibiotics, amikacin (483) was most commonly prescribed followed by cefotaxime (414) and ceftriaxone (301). Conclusion: In our study, we have found that antimicrobials were most commonly used drugs in the form of injectable. To prevent development of antimicrobial resistance, there is necessary of antibiotic policy in each and every hospitals of India.
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Background: Quality and safety of prescribing in older people remains a global healthcare concern and inappropriate prescribing is a major public health issue because of its direct association with morbidity, mortality and wastage of health resources in this age group. Very limited data is available on the drug utilization pattern in geriatric population and the present study was carried out to see the prescription pattern in geriatric population in this part of the world.Methods: The present study was conducted by the department of pharmacology in outpatient department of geriatrics in a tertiary care centre to look into the prescription pattern among geriatric age group.Results: A total of 237 prescriptions were collected, out of which 108 (45.56%) were males and 129 (54.44%) were females. The majority of the patients were in the age group of 60-69 years (n=141, 59.5%). The most commonly found comorbidity was hypertension (63.29%) and antihypertensive agents (74.68%) were the most frequently prescribed class of drugs. Calcium (37.57%), budesonide (32.91%), thyroxine (27.84%) and pantoprazole (25.31%) were the most common individual drugs prescribed.Conclusions: Like other studies on geriatric population polypharmacy was also observed in the present study and periodic therapeutic audit is essential to ensure rational medicine use.
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Background: 10million could die every year due to antibiotic resistant infections by 2050 unless the threat is addressed. Irrational use of antibiotic use is a global phenomenon. So, 50% all anti bionics are prescribed, sold are dispensed inappropriately, while 50% of patients are not taking antibiotics correctly (WHO 2004).Methods: This was a cross section study it was a conducted in RVS institute, tertiary care teaching hospital. Chittoor. The questionnaire was distributed along the faculty resident doctors and senior faculty of this RVS institute Where their knowledge, attitude, practice regarding antibiotic prescription and resistance was assessed by a five point likert scale, whose response ranged from strongly agree to disagree. Some questionnaire were of useful or nor useful and yes or no.Results: Irrational prescription of antibiotics is worldwide problem and also in India was known to most of the physicians in our institute (n=95%) of participants. 80% subjects answered that prescription writing influenced by senior faculty and medical representatives. 50% subjects answered that antimicrobial resistance is a problem in daily practice.80 % subjects answered that most of the antibiotics available as over the counter drugs (OTC).Conclusions: This study concludes, prescription writing influences by senior faculty and medical representatives. It’s important to monitor and auditing prescription writing based on WHO Antibiotic guidelines to prevent resistance. Strict vigilance of OTC sales of antibiotics to prevent resistance.
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Background: Acne Vulgaris is the most common skin disorder of the pilosebaceous unit with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity, affecting about 80% of teenagers and has considerable psychological and social consequences and physical disability. Use of established topical and oral drugs assumes paramount importance in the treatment of acne vulgaris. Therefore, periodic auditing of prescription is necessary to increase therapeutic benefit and decrease adverse effects. Aim and objectives of the study was to evaluate the pattern of prescription and its rationale in the drug therapy of acne vulgaris. To monitor the adverse effects, if any.Methods: A prospective, hospital based, observational study. Data was collected for a period of 1 year from January 2015 to December 2015 from the outpatient records in the OPD of Dermatology at Justice K.S. Hegde Charitable Hospital, Deralakatte, Mangalore, in a specifically designed proforma.Results: The prescription data of 346 patients were analyzed of which 45.1% were males with an average age of 21.94±0.3 years. Among the four grades of Acne Vulgaris, Grade II (53.17%) was more prevalent followed by Grade I (26.58%), Grade III (13.87%) and Grade IV (6.35%). The number of drugs prescribed for topical use was 514 of which the most commonly prescribed drugs were Benzoyl Peroxide (19.46%), a combination of Tretinoin and Clindamycin (17.12%), Tretinoin alone (12.45%), Clindamycin alone (10.51%) etc. The number of drugs prescribed for systemic use was 98 consisting of Doxycycline (55.1%), Azithromycin (34.7%), Isotretinoin (6.12%) and Erythromycin (4.08%).Conclusions: There was rationality in most of the prescriptions giving no scope for polypharmacy.
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Background: High rate of antibiotic prescription is commonly encountered in hospital settings. Although the problem of the irrational use of antibiotics is particularly acute in rural health centers of developing countries, antibiotic utilization studies in such areas are scarce. In this study, we aimed to compare antibiotic prescription patterns between inpatients and outpatients in a rural general hospital. Methods: Inpatient and outpatient records were evaluated during a 1-month period. Data including patients’ demographics, length of hospital stay, final diagnosis, antibiotic regimen, dosing, rout of administration, microbiological culture/sensitivity tests and other laboratory data were retrieved from the hospital information system. Results: The number of prescriptions with at least one antibiotic was 686/1410 (48.6%) cases and 3812/6126 (62.2%) cases for inpatient and outpatient prescriptions, respectively. The mean number of antibiotic per prescription was 1.7±0.7 and 1.3±0.8 for inpatient and outpatients, respectively (p<0.05). Ceftriaxone had the highest rate of prescription among hospitalized patients with 791 (35.2%) times encounter while penicillin constituted the largest proportion of outpatient administrations with 2505 (29.8%) times. About 79% of inpatient and 62% of outpatient prescriptions containing final diagnosis data had the correct indication. Conclusion: Our study showed that implementation of strict regulations for antibiotic use is extremely needed in this rural hospital. Establishing local guidelines, providing adequate education for healthcare professionals and putting restrictions for broadspectrum antibiotic use can be beneficial.
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OBJECTIVE:To evaluate the application of prescription comment software in our hospital. METHODS:552 pre-scriptions were evaluated by pharmacist A,B and software,and the Kappa values were calculated to evaluate the reliability of the software. The results of comment by pharmacist B and by software were combined (serial test and parallel test),and then com-pared with the results of comment by pharmacist A. The sensitivity,specificity and Youden's index were calculated to evaluate the reliability of the software. The comment results of 552 prescriptions by pharmacist A for twice were compared to calculate Kappa value,and it was used to evaluate the comment consistency of pharmacist A. RESULTS:The pharmacist A,B comment results and software comment results showed poor consistency,and Kappa value were 0.020 2 and 0.002 0,with significant difference (P<0.001);pharmacist A comment results had strongest consistency with pharmacist B comment results,and Kappa value was 0.843 0,with no significant difference(0.1
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Introducción: los fitofármacos constituyen una valiosa opción terapéutica en el contexto cubano actual, su uso racional es responsabilidad del personal que prescribe. Objetivo: valorar el impacto social de una estrategia de intervención sobre el uso racional de la medicina verde en el Policlínico Teniente Tomás Rojas, municipio Céspedes, provincia de Camagüey, en el período comprendido de enero de 2010 hasta junio de 2011. Métodos: el universo estuvo constituido por 72 profesionales, de ellos se seleccionó una muestra de 20 por método aleatorio simple que cumplieron los criterios de inclusión y exclusión. La estrategia se estructuró en 3 etapas: evaluación de diagnóstico inicial, intervención educativa y evaluación del impacto en la práctica asistencial. Los datos se recogieron en encuestas, los análisis estadísticos se efectuaron en el sistema EPISTAT. Resultados: se observó en el diagnóstico inicial 15, 55 y 30 por ciento, con evaluaciones de 4, 3 y 2, respectivamente. En la evaluación de la intervención educativa 70 por ciento obtuvo puntuación entre 4 y 5, 30 por ciento entre 2 y 3 puntos, y en la evaluación del impacto en la práctica asistencial de la estrategia educativa 100 por ciento de los profesionales interiorizó la importancia y el uso de la medicina alternativa. hubo 66,7 por ciento de aumento en las indicaciones médicas y 75 por ciento de aceptación por la población. Conclusiones: con el diagnóstico realizado y la estrategia aplicada se obtuvieron cambios positivos en la prescripción, mayor conocimiento y actitudes positivas de los profesionales hacia el uso racional de la medicina verde, con favorable impacto social
Introduction: phytomedicines are a valuable therapeutic option in the Cuban current context. Their rational use is the responsibility of the personnel prescribing them. Objective: evaluate the social impact of an intervention strategy for the rational use of natural medicine at Teniente Tomás Rojas polyclinic, municipality of Céspedes, province of Camagüey, in the period extending from January 2010 to June 2011. Methods: the study universe consisted of 72 professionals, of whom a sample of 20 was randomly chosen among those meeting the inclusion and exclusion criteria. The strategy was structured into three stages: evaluation of the initial diagnosis, educational intervention, and evaluation of the impact on health care. Data were collected from surveys. Statistical analyses were performed with the Epistat program. Results: the initial diagnosis revealed 15, 55 and 30 percent, with scores of 4, 3 and 2, respectively. In the evaluation of the educational intervention, 70 percent obtained scores between 4 and 5, and 30 percent between 2 and 3. In the evaluation of the impact of the educational strategy upon health care, 100 percent of the professionals internalized the importance of the use of alternative medicine. There was a 66.7 percent increase in medical indications, and 75 percent acceptance by the population. Conclusions: the diagnosis conducted and the strategy implemented brought about positive changes in the prescription of natural medicines, as well as greater awareness and a more positive attitude on the part of professionals toward the rational use of natural medicine, resulting in a favorable social impact