Résumé
Background: To study and describe the prevailing prescription trend in burns patients in a tertiary care rural hospital. Methods: This was a retrospective observational study. Total 100 patients diagnosed with burn injury and admitted during Jan 2012 to Dec 2013 were included in the study. The demographic details, details of burn injury & treatment received were obtained from the medical record section of Dhiraj General Hospital, Piparia. Drug prescriptions were analyzed using Microsoft Excel for total number of drugs per prescription, various classes of drugs prescribed and group of antibiotics commonly prescribed. Results: Most common age group affected was 20-40 years. The female to male ratio was 1.8:1. Average number of drugs prescribed was 6.8 with a range of 4-9 drugs per prescription. All prescriptions (100%) contain antimicrobials, analgesics and antiulcer drugs. Among antimicrobials, ceftriaxone was most commonly prescribed followed by amikacin and amoxicillin + clavulanic acid. Only 18% patients were immunized against tetanus. Conclusions: Females are more vulnerable to burn injuries. Polypharmacy was observed in prescriptions. Systemic antibiotic should be used with caution to prevent emergence of resistant microorganisms. Results of the present study indicate that some aspects of drug treatment need to be rationalized in order to achieve better patient care.
Résumé
Each year many patients are hospitalized due to adverse drug reactions. Adverse reactions are the recognized hazards of drug therapy and they can occur with any class of drugs and many studies revealed that the incidence is more in case of antibiotics. Amoxicillin is a broad spectrum, bactericidal, beta lactam antibiotic, commonly used to combat various infections. Penicillin group of drugs are known to cause cutaneous drug eruptions especially in pediatric population. Most of the time, these eruptions are mild in nature, however, sometimes they represent the early manifestation of rare, severe drug-induced cutaneous reactions, such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Toxic Epidermal Necrolysis (TEN) is a rare, life threatening dermatological disorder that is usually induced by medications. Seventy percent of the cases of TEN are drug induced, most commonly implicated drugs being anticonvulsants, antibiotics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDS). Here, we report a case of toxic epidermal necrolysis induced by amoxicillin in a 16 year old female patient. Rigorous treatment with systemic corticosteroids and immunoglobulins helped in recovery of the patient. The case is being reported to emphasize the need for efficient pharmacovigilance in order to motivate adverse drug reaction reporting so as to gather more and more data regarding adverse drug reactions. Through this report, we also seek the support of everyone concerned to detect and, if possible, prevent adverse reactions to drugs.