Trends of prescribing for out-door geriatric patients in a private hospital of Bangladesh.

The present study was performed to find out the prescribing patterns of the doctors for geriatric patients, to characterize the behavior of the outdoor geriatric patients of a selected private hospital and to investigate whether polypharmacy is a suitable indicator for occurrence of unnecessary or irrational drug therapy. A prospective study was carried out with the help of a structured questionnaire and the prescriptions of the patients. Patients aged 65 year and above were included in the study. A total of 35 patients were interviewed and their prescriptions were collected after taking their consent. Among the patients, hypertension was found to be most prevalent (46%) followed by diabetes mellitus (16%). Chief complaints were chest pain (41%), joint pain (37%), muscle pain (34%) and respiratory distress (27%). About 34% of the patients did not comply with the prescription and 75% did not take regular physical exercise. Stress (49%) and insomnia (41%) were common among the patients. Polypharmacy was observed in 69% of the patients and an average of 5.5 drugs was given to them. Losartan potassium was the mostly prescribed (31%) drugs followed by esomeprazole (20%) and multivitamins (17%). Unnecessary drug use problem can be prevented by the rational prescribing of drugs by the practitioners. Any medications without therapeutic benefit, goal or indication should be avoided during prescribing for geriatric patients. This study reveals the prescription trends, and indicates possible areas of improvement in prescribing practice.

Accelerated stability and antimicrobial sensitivity studies of amoxicillin dry suspensions marketed in Bangladesh.

Since its introduction, amoxicillin dry suspension has been the mainstay for the antibacterial therapy for paediatric patients. But use of substandard preparation of antibiotic is one of the most important causes of microbial resistance. The present study has been carried out to evaluate the quality and stability status of 10 marketed amoxicillin dry suspensions of Bangladesh. All the brands were analyzed for their potency using chemical and microbiological methods described in the United States Pharmacopoeia and British Pharmacopoeia. Potency determination was done at three controlled temperatures - refrigerated, room and elevated (40C) showed that two samples were over potent but one sample was substandard out of the 10 samples. The initial potencies of the two samples were within USP range when freshly reconstituted but after 7 days, at room temperature, potencies deteriorated and came down to 90%. In refrigerated condition, all the samples remained in good condition and at 40C, a considerable loss of potencies in all the samples were observed. Results of microbiological assay also support the results of chemical assay. The study emphasizes the necessity of routine inspection, monitoring and evaluation of quality of formulations containing amoxicillin dry syrup.

A comparative study of physical parameters of selected ketorolac tromethamine tablets available in the pharma market of Bangladesh.

Quality of pharmaceutical product is very important because drugs must be marketed as safe and therapeutically active formulations whose performance is consistent and predictable. The evaluation of the physical characteristics of the pharmaceutical products can ensure their quality as well as bioavailability and impart optimum therapeutic activity. Ketorolac tromethamine was chosen for this comparative study because this drug is widely used worldwide for treating moderate to severe pain. The present study compared the weight variation, hardness and the abrasion withstanding ability of eight brands of Ketorolac tromethamine tablets marketed in Bangladesh following USP guidelines. All eight brands of Ketorolac tromethamine tested conformed to the USP weight variation test. All the brands had average hardness of ≥3 kg which was satisfactory for immediate release tablet like ketorolac tromethamine. All the brands had shown their friability variation within ±1% range specified by USP. Standard deviation was calculated among all the brands which was very close to individual percentage friability of all the brands. All the brands of ketorolac tromethamine complied with USP requirements of physical quality parameters. It follows that these brands will show good disintegration and dissolution profile which would further help in achieving optimum bioavailability and in fulfilling the patient demands.

Antibiotic sensitivity pattern of causative organisms of neonatal septicemia in an urban hospital of Bangladesh.

Background: The information of the sensitivity pattern of the causative organisms is very important for effective control of septicemia in neonates. OBJECTIVE: To determine the proportion and profile of pathogenic bacteria in the blood cultures of the neonates with clinically suspected septicemia and their susceptibility pattern to antimicrobial agents for developing a unified antibiotic treatment protocol. Materials and Methods: A cross-sectional retrospective study was conducted over a period of 3 year and 4 months (39 months). The study included 1000 patients admitted in the selected hospital in Bangladesh. Blood samples for culture were taken aseptically before starting antibiotic therapy. Microorganisms were isolated and identified by standard microbiological processes which include colony morphology, Gram stain, and biochemical profiles. Antimicrobial sensitivity patterns were performed by Kirby-Bauer's disc diffusion method against imipenem, ciprofloxacin, ceftazidime, chloramphenicol, netilmicin, gentamicin, ceftriaxone, aztreonam, cefotaxime, cephalexin, and ampicillin. Results: Among the patients, 633 (63.3%) were males and 367 (36.7%) were females. Blood cultures were found positive in 194 (19.4%) neonates. The organisms isolated were Pseudomonas spp. (31.4%), Klebsiella pneumoniae (23.2%), Staphylococcus aureus (12.4%), Escherichia coli (7.2%), Acinatobactor (5.7%), Gram-negative Bacilli (4.1%), Flavobacterium spp. (3.6%), Serratia spp. (5.7%), Citrobacter fruendi (3.1%), Streptococcus species (2.6%), and Enterobacter spp. (1.0%). A majority of the bacterial isolates in neonatal sepsis were found sensitive to imipenem (91.8%) and ciprofloxacin (57.2%) and resistant to commonly used antibiotics, eg. ampicillin (96.4%) and cephalexin (89.2%). Conclusion : The problem can be mitigated by careful selection and prudent use of available antibiotics.