Assessment of antimicrobial prescribing and rationality of drug usage in general practitioners in Pune city, India.

ABSTRACT

Background: Most of the common ailments are managed by general practitioners (GPs). GPs prescribe major bulk of the drugs sold in the market. Naturally, irrational use of drugs at this level could lead to disastrous consequences. So this study was undertaken to determine prescribing pattern of Antimicrobials (AMA) and the rationality of drug usage by GPs in Pune city. Methods: It was a cross-sectional study. Pune city was divided into 5 zones. MBBS, BAMS and BHMS GPs doing Allopathic practice were selected randomly. 2 GPs of each specialty per zone were selected; this gave us 10 GPs of each degree – so total 30 GPs.30 Prescriptions at each GP were collected – total 900 prescriptions. The following parameters were studied- Diagnosis of patient, Average no. of drugs/prescription Percentage of AMAs prescribed, Rationality of AMA, Selection of AMAs diagnosis wise, Rationality of Prescription. Results: More than 75% patients coming to GPs were suffering from communicable diseases. Average no. of drugs / prescription and percentage of prescription with AMAs was high in all GPs. Macrolides was the most common group of AMA used by MBBS whereas Cephalosporins was used by BAMS and BHMS. Irrational use of AMAs was high in BHMS GPs. Use of irrational FDCs, banned drugs, steroids was high in BAMS GPs. Conclusions: There are deficiencies in prescription practices among all GPs. Not only are GPs prescribing the highest number of AMAs per prescription anywhere, their prescription practices for common health problems are highly inappropriate. High level of irrational use of drugs by BAMS and BHMS GPs are cause of concern.