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OBJECTIVES@#This study evaluated the antibiotic prescribing patterns in pediatric patients in the Out Patient Department (OPD) of the Philippine Children’s Medical Center (PCMC) where it may encourage drug monitoring and improvement in the utilization of antibiotics in the department.@*MATERIALS AND METHODS@#A descriptive, cross-sectional study involving patient encounters selected using convenience sampling was conducted at the outpatient department of PCMC. All previously healthy pediatric patients aged 3 months to 18 years diagnosed with pediatric community- acquired pneumonia (PCAP) with no known acute and chronic comorbidities were included. The observed values of the antibiotic prescribing indicators were compared with the optimal values recommended by the World Health Organization (WHO), and the Index of Rational Drug Prescribing (IRDP) was calculated.@*RESULTS@#A total of 600 patients diagnosed with PCAP were included in the study seen at the PCMC OPD from January 2020 to July 2022. Ninety-six percent of the patient encounters had at least one antibiotic prescribed (SD + 0.20). The average number of medicines prescribed per patient encounter was 2.05 (SD + 0.85). Of these, 100% were prescribed by generic name and were prescribed from the essential drug list. The most commonly prescribed medications were antibiotics (43.17%) with coamoxiclav (42.93%), amoxicillin (37.76%), and cefuroxime (7.59%) being the top three commonly prescribed antibiotics.@*CONCLUSION@#With respect to the IRDP, PCMC scores well with 3.16 where the most rational score is 4. However, this study highlights the high occurrence of prescribing antibiotics in the institution.
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Outpatients , PediatricsABSTRACT
Background: Antimicrobial agents (AMAs) are an integral part of management of diseases in the department of general medicine, and a wide range of antimicrobials are used for prevention, prophylaxis, or treatment of various infectious diseases. Systematic studies regarding the pattern of AMAs use may help in improving the quality of patient care by evidence-based practices and also in formulating effective antimicrobial usage guidelines. Aim and Objectives: The objectives of this study were as follows: (i) To analyze the prescribing trends of Antimicrobials in Medicine wards of a Tertiary Care Hospital; (ii) to assess safety profile of AMAs; and (iii) to analyze extraneous factors influencing AMAs prescription. Materials and Methods: The prospective analysis of Antimicrobial prescriptions of Medicine wards for the period of July 2018–August 2019. The class of AMAs, formulation, dose, route of administration, frequency, and duration of administration and their safety was assessed using the WHO indicators. Results: The most frequently used AMAs were third generation cephalosporin (Ceftriaxone) and it was frequently combined with metronidazole. The choice of initial AMAs was empirical, which was later changed depending on the clinical response. The AMAs were effective in preventing or controlling infections and well tolerated without any serious adverse reactions or drug interactions. Conclusions: The rational use of AMAs is necessary to control worldwide emergence of antibacterial resistance, side effects, and to reduce the cost of treatment.
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Background: Drug utilization research is a part of Pharmacoepidemiology defined by the WHO as the study of marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences. Conducting periodic studies of pattern of drug use in our hospital setting is essential to critically analyse the current hospital drug policies and to make recommendations based on various guidelines to improve upon the current drug usage pattern. Aims and objectives of the study was to generate data on the drug utilization pattern in Medical ICU and to monitor antimicrobial usage in MICU.Methods: Patients who were admitted in medical ICU of Hassan institute of Medical Sciences were recruited based on inclusion-exclusion criteria. The study was conducted over a period of 3 months from April 2018 to June 2018. The demographic and clinical treatment data of patients were collected. The prescriptions were assessed as per the WHO indicators.Results: Common causes of admission were suicidal poisoning, snake bite, viral thrombocytopenia, myocardial infarction and stroke. The average duration of stay was 5.74 days and average number of drugs/patient was 5.26. Pantoprazole, Ranitidine, Ceftriaxone, Atropine, Pralidoxime, ASV, Ondansetron, and N-acetylcysteine were commonly prescribed drugs. 42.4% of drugs were prescribed by generic names and 84.2% of the drugs were prescribed from Essential Medicine List.Conclusions: This study will provide database to address prescription protocols and guide appropriate use of drugs in the ICU setting.
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Background: Epilepsy is the most common neurological condition with 65 million cases of active epilepsy found worldwide. The incidence is approximately 0.3 - 0.5% in different world populations with a prevalence rate of five to ten per thousand people. The aim of the present study was to evaluate the prescriptions according to WHO/INRUD drug use indicators and to study the adverse effects to antiepileptic drugs (AEDs).Methods: A cross sectional survey based observational study of 1year duration was conducted at tertiary healthcare hospital. Prescription data of patients (n=361) with Epilepsy from Neurology department was analysed using WHO indicators. The demographic data, type of seizures, AEDs prescribed and adverse drug reactions (ADRs) reported by the patients were recorded. Statistical analysis was done using Microsoft excel 2013.Results: A total of 593 AEDs were prescribed to 361 patients. Average number of AEDs prescribed per prescription was 1.65±0.78 (S.D) with only 02% of newer AEDs. Generalized Tonic Clonic (GTC) was the most common seizure with 55.68%. Phenytoin (32%) was commonly prescribed followed by valproate for GTCS. Carbamazepine was commonly prescribed for partial seizures. Out of 15 ADR cases that has been recorded, phenytoin (73%) was associated with most ADRs followed by valproate (20%). 53% patients were on Monotherapy, 31% on dual drug therapy.Conclusions: Older AEDs are still commonly prescribed drugs. Prescription of newer AEDs to be encouraged, as study revealed majority of adverse effects to drugs like phenytoin and valproate. Study concludes the need of creating awareness of reporting of adverse event to AEDs, in treating physician.
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Background: Nowadays irrational use of drugs is a major problem inspite of extensive programs being carried out on rational use of medicines. Therefore, in present study we evaluated OPD prescriptions for rationality and their adherence to prescription format.Methods: A prospective, observational study was carried out in 511 outdoor patients for a period of three months. Quality of prescription writing was assessed for completeness of information and legibility. Rationality was analyzed using WHO core prescribing indicators.Results: Basic information of patient and name of department were written in all the prescriptions. Diagnosis was mentioned in 76.33% cases. Dosage forms, dose, frequency and duration of treatment were mentioned in 97.26%, 73%, 80.04% and 80.23% of prescriptions respectively. About 73.78% prescriptions were legible. Doctor’s name, signature and registration number were present in 80.82%, 82.97% and 15.66%. Total number of drugs in 511 cases was 1074. Average number of drugs/ prescriptions was 2.1±0.8. Drugs were prescribed by generic name in 25.14% cases; drugs from EDL were 57.36%. Antimicrobial agents, injectable drugs and FDCs were prescribed in 25.83%, 12.13% and 39.14% cases. The most commonly prescribed drugs were analgesics, GIT and cardiovascular drugs.Conclusions:This study shows possible areas of improvement in prescription practice that is generic prescribing, use of essential medicines, restraint in use of irrational fixed dose combinations and better quality of prescribing in terms of inclusiveness of information, legibility and doctor’s details.
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Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs.