scholarly journals RATIONALE OF ANTIBIOTIC PRESCRIPTION IN PATIENTS VISITING A TERTIARY CARE SOUTH INDIAN HOSPITAL

2021 ◽  
pp. 27-30
Author(s):  
MOHAMED AHMED ◽  
PAWAN KUMAR ◽  
KISHORE DV ◽  
PRABHAT KUMAR ◽  
RUBEENA KAUSER ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
General Medicine ◽  
Critical Issue ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Specific Patient ◽  
South Indian

Objective: Antimicrobials are the class of drugs that are used irrationally in most cases leading to rise in instances of antimicrobial resistance altering the effect of such agents. Antimicrobial resistance has become a critical issue universally nerving the need to monitor the utilization pattern and rationality in prescribing of antibiotics. This helps in selection of most appropriate antibiotic for the specific patient and achieving the goals of the therapy. Methods: A prospective cross-sectional study with a sample size of 600 participants was conducted in department of general medicine of a tertiary care hospital. Inpatients prescribed with antibiotics were included in the study and their case sheets were reviewed to analyzing the prescribing pattern. The medication usage pattern was then assessed for rationality in prescribing was evaluated. The results obtained were statistically analyzed using SPSS Software. Results: It is noted that a more number of males participated and the greatest number of the patients were from the age group of 31-45. The diagnosis found in the majority of the patients was respiratory tract infection followed by others. On scrutinizing the prescriptions, it was noted that cephalosporins and penicillins were most often prescribed, and on an average single, antibiotic was frequently used with the preferred route of administration in most of the prescriptions being injection route. Though many of the antibiotics were prescribed empirically, it was observed that 59% of them were most appropriately dosed and maximum patients that are around 57% were cured from their illnesses. Conclusion: This study provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship programs. The culture and sensitivity testing suggested that the drug resistance was more for most commonly prescribed antibiotics in the hospital. Increased targeted prescribing based on sensitivity tests will bring down the high use of empiric broad-spectrum antibiotic use.

Antimicrobial Resistance Pattern of Uropathogenic Escherichia coli and Klebsiella species Isolated in a Tertiary Care Hospital of Sylhet

2018 ◽  
Vol 30 (2) ◽  
pp. 61-66
Author(s):  
Md Mahbubur Rahman ◽  
Osul Ahmed Chowdhury ◽  
Md Moynul Hoque ◽  
Syed Anwarul Hoque ◽  
Sultana Mehnaz Rahman Chowdhury ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
High Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Geographical Area ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Klebsiella Species ◽  
Sensitivity Pattern

The rapid emergence of antimicrobial resistance in major uropathogens has created a global threat especially in the developing countries. In Bangladesh, prescribers of different regions generally diagnose microbial infection on clinical judgment and select antimicrobial on empirical basis, which unfavorably affects the sensitivity pattern of microbes. The present study was designed to determine the prevalence of antimicrobial resistance of Escherichia coli and Klebsiella species isolated from patients with UTI in a tertiary care hospital. This was a cross sectional study conducted at Sylhet MAG Osmani Medical College Hospital, Sylhet from 1st January to 31st December 2016. A total of 200 clinically suspected urinary tract infection patients aged 16-85 years were included in this study. The isolated Escherichia coli and Klebsiella species were tested for antimicrobial susceptibility according to the guideline of Clinical and Laboratory Standards Institute (CLSI) 2011 using the modified Kirby- Bauer disc diffusion technique. Out of 107 pus cell positive ( 05/HPF) urine samples, 75 (70.1%) yielded significant bacteriuria of which 49 (65.3%) were Escherichia coli and 9 (12%) were Klebsiella species. The isolated Escherichia coli showed absolutely high resistance to ampicillin and cefuroxime (100%), moderately high resistance to ceftazidime (81.6%), ciprofloxacin (77.6%), cotrimoxazole (75.5%), cefotaxime (67.4%) and ceftriaxone (59.2%), moderate rate of resistance to amikacin 48.9% and imipenem 46.9% and least rate of resistance to gentamicin (22.5%), nitrofurantion (22.5%) and netilmicin (6.1%). In addition, Klebsiella species revealed completely resistance to ampicillin, cotrimoxazole, cefuroxime, cefotaxime, ceftriaxone, ceftazidime (100%), moderately high resistance to imipenem (88.9%), nitrofurantoin (77.8%), moderate resistance to ciprofloxacin (44.4%), amikacin (33.3%) and gentamicin (33.3%) and least resistance to netilmicin (11.1%). Hence very high resistance rates of 1st line drugs found in uropathigenic Escherichia coli & Klebsiella species, it is necessary to diagnose clinically followed by culture and sensitivity testing. Regular antibiotic surveillance of a particular geographical area is required to establish reliable information regarding susceptibility pattern of uropathogens in order to preserve the continued usefulness of most antimicrobial agents.Medicine Today 2018 Vol.30(2): 61-66

scholarly journals AN EVALUATION ON PRESCRIBING PATTERN OF ANTIBIOTICS IN PAEDIATRIC INPATIENTS AT TERTIARY CARE HOSPITAL

2019 ◽  
pp. 53-57
Author(s):  
SABISHRUTHI S ◽  
KAVITHA S ◽  
JAGAN NATHAN B ◽  
KALICHETI PRIYANKA ◽  
ARSHATH A
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Minimum Cost ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Prescribing Pattern ◽  
Case Record ◽  
Tract Infections ◽  
The Cost

Objective: Our objective of the study was to evaluate the prescribing patterns of drugs with cost analysis in pediatric inpatients at tertiary care hospital. Methods: It is an observational prospective study carried out in pediatric inpatients with a sample of 180 patients based on age, inclusion, and exclusion criteria for period of 3 months. The patient’s data were collected using patient case record form and analysis of the data was done. Results: Of 180 patients data were collected, the results show that majority of gender admitted in the hospital were male children 94 (52%) and many are from age group of early childhood (2–5 years) 67 (37%). Respiratory tract infections are diagnosis most commonly analyzed and off overall 236 prescribed antibiotics cephalosporins 86 (43%) and combination of amoxicillin + clavulanic acid 25 (71%) is the class of antibiotics prescribed higher than other class of drugs. Parental 173 (73%) route of administration was observed to be followed more than other route. The percentage of cost variation of antibiotics observed in the study reveals that the huge variations were seen in the cost of medication in maximum and minimum cost. Conclusion: The present study reveals that the prescribed antibiotics were as per the diagnosis of the patient and not by proceeding proper culture sensitivity testing. Hence, awareness about antibiotic must be created among practicing physicians to increase the therapeutic compliance of the patient.

scholarly journals Drug Utilization Evaluation of High Alert Medications in Intensive Care Units of Tertiary Care Teaching Hospital

2021 ◽  
Vol 11 (1-s) ◽  
pp. 94-101
Author(s):  
Meda Venkata Subbaiah ◽  
K Leela Prasad Babu ◽  
Dudekula Manohar ◽  
Adluru Sumalatha ◽  
Pinjari Mohammed ◽  
...  
Keyword(s):  
Intensive Care ◽  
Drug Utilization ◽  
Treatment Guidelines ◽  
Tertiary Care ◽  
Hospital Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
South Indian ◽  
Utilization Patterns ◽  
Drug Utilization Evaluation

Introduction: The utilization of HAMs is crucial in emergency and intensive care departments, as they can cause a significant amount of damage to the patient and health care members if we could not follow the standard treatment guidelines. Drug utilization evaluation/review involves a comprehensive review of the patient’s prescription and medication data before, during, and after dispensing to ensure appropriate medication decision making and positive patient outcomes. Objective: This study was taken up given finding the utilization patterns and rectifying the issues with the usage of high alert medications (HAMs) and improving their utilization. Methodology: A cross-sectional study was conducted for 6 months at a south Indian tertiary care hospital. Treatment guidelines were prepared to compare the actual drug use. Data were collected both retrospectively and prospectively by patients and care taker’s interview, medication chart review, and discussion with prescribers and applied WHO DUE indicators to evaluate utilization patterns. Results: Of 362 cases, 57.73 % were males/ and the majority geriatrics. Among all HAMs Insulin is frequently prescribed (34.5 %) and the costly drug is Enoxaparin. Generic names were used in writing prescriptions and parenteral formulations were mostly used. Around 9 ADRs were identified and managed, and a total of 133 moderate to severe Drug-Drug Interactions were found, of them, only 2 were actual. Conclusion: With this study, we conclude that the use of HAMs was found to be appropriate as per the guidelines as we observed very few DRPs with the study drugs. Keywords: HAM, DRP’s, DUE, ICU, DDD

scholarly journals A study on the bacterial isolates from blood cultures of a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 171-174
Author(s):  
KMS Mohamed Ali ◽  
K Girija
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Tertiary Care Centre ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

scholarly journals Prescription analysis of hypolipidaemic agents in the department of cardiology in a tertiary care hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 2557
Author(s):  
Manju Gari ◽  
Megha Bansal
Keyword(s):  
Lipid Profile ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Common Disease ◽  
Care Hospital ◽  
Dose Ratio ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Common Drug ◽  
Daily Dose

ABSTRACTBackground: The objective of the present study was to evaluate the prescribing pattern of hypolipidaemic drugs in the outpatient department of cardiology in a tertiary care hospital.Methods: A cross-sectional study was conducted in the department of cardiology for the period of 3 months. A total of 526 prescriptions were analyzed for variants such as the disease patterns, the type of hypolipidaemic drugs which are prescribed for those diseases, the prescribing daily dose of the hypolipidaemic drugs and the prescribing daily dose/daily defined dose ratio of the drugs.Results: On evaluation of the prescriptions, it was conferred that both the patients of normal lipid profile (34.77%) and abnormal lipid profile (65.18%) were prescribed hypolipidaemic drug. Diabetes with hypertension (35.74%) was the most common disease for which hypolipidaemic drugs were prescribed. Atorvastatin (30.98%) was the most common drug which was prescribed as monotherapy, whereas atorvastatin with aspirin and clopidogrel (17.49%) was the most common drug prescribed in combination.Conclusions: Use of statin has become very prevalent with increasing trends of use in both normal and abnormal lipid profile patients, suggesting consideration of rational use of statins to follow good prescribing pattern so that morbidity and mortality can be prevented.

scholarly journals PRESCRIPTION PATTERN OF DIURETICS IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
P G Chithara ◽  
Dr. Yogananda R ◽  
Dr. Bharathi DR
Keyword(s):  
Drug Interaction ◽  
Tertiary Care ◽  
General Medicine ◽  
Oral Route ◽  
Prescribing Patterns ◽  
Research Centre ◽  
Intravenous Route ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Drug Drug Interaction

Diuretics are drugs that increase the rate of urine flow; clinically useful diuretics also increase the rate of excretion of Na+ (natriuresis) and an accompanying anion, usually Cl. Diuretics are a mainstay of therapy for a wide variety of diseases ranging from hypertension to the nephrotic syndrome. Objective: To study the prescribing patterns of diuretics in General Medicine and ICU. To assess the drug-drug interaction of diuretics. To study the route of administration of diureics. Materials and methods: A prospective observational study was conducted over a period of six months at general medicine and ICU department of Basaveshwara Medical College and Hospital and Research Centre, Chitradurga.a otal of 100 in-patients are included as study subject. Results: Mostly prescribed diuretic in this study were furosemide (52.9%), followed by mannitol (28.1%), spironolactone (11.57%), torsemide (5.79%), amiloride (0.82%) and hydrochlorothiazide (0.82%). Out of 100 prescriptions 84.4% of diuretics prescribed in intravenous route, 15.6% of diuretics prescribed in oral route. Out of 100 prescriptions total 89 drug interactions with diuretics are found. In that 2.3% major interactions and 67.4% moderate interactions and 30.3% minor interactions are found. Conclusion: Prescription monitoring helped to reduce the diuretic usage errors with respect to dose and drug-drug interaction with other prescribed drugs to provide better patient care. Keywords:  prescribing pattern, drug-drug intraction, diuretics

scholarly journals A cross-sectional observational study on drug utilisation pattern, prevalence and risk factors for the development of diabetic nephropathy among type 2 diabetic patients in a south indian tertiary care hospital

2020 ◽  
Vol 11 (1) ◽  
pp. 93-108
Author(s):  
Madhavi Mannam ◽  
Lavanya Nalluri ◽  
Dhanalakshmi Pinnika ◽  
Mounika Pothuraju ◽  
Ravindrababu Pingili ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Nephropathy ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
South Indian ◽  
Type 2 Diabetic

Diabetic nephropathy is the leading cause of the end-stage renal disease (ESRD) worldwide, and it is estimated that ~ 20% of type 2 diabetic patients reach ESRD during their lifetime. The objective of the present study was to assess the drug utilization pattern, risk factors, and prevalence of diabetic nephropathy in patients with type 2 diabetes mellitus in a south Indian tertiary care hospital. A cross-sectional observational study was conducted on 613 subjects (254 with and 359 without diabetic nephropathy). Prevalence of diabetic nephropathy was measured, and risk factors for the development of diabetic nephropathy were determined by calculating odds ratios using graph-pad prism statistical software, and drug utilization pattern was assessed. Nephropathy was significantly higher in subjects who are married (98.8%, OR, 3.903; 95% CI, 1.125-13.54, P=0.0211),  poorly educated (61%, OR, 0.3670;95%CI, 0.2635-0.5112, P<0.0001), house wives (44.4%, OR, 0.5492; 95% CI, 0.3432 - 0.8789, P=0.0120), rural residents (51.2%, OR, 0.3943; 95% CI, 0.2820-0.5513, P<0.0001) and risk factors were hypertension (37.44%, OR, 4.131; 95% CI, 2.687-6.350, P<0.0001), other diseases (36.51%, OR, 4.963; 95% CI, 3.202 -7.692, P<0.0001), Endocrine diseases (9.53%, OR, 2.460; 95% CI, 1.433- 4.224, P=0.0009), history of CVD (7.90%, OR, 17.20; 95% CI, 7.049- 41.95, P<0.0001), HbA1c (36.1%, OR, 3.380; 95% CI, 2.157- 5.295, P<0.0001), low HDL (23%, OR, 0.5961; 95% CI, 0.3572 - 0.9947 , P=0.0470), high FBS levels (29.3%, OR, 6.111; 95%CI, 1.283 -29.10, P=0.0113), high triglyceride levels (39.8%, OR, 0.6077; 95%CI, 0.3878 -0.9523, P=0.0293), high serum creatinine (28.3%, OR, 154.3; 95% CI, 37.92- 627.7, P<0.0001), duration of T2DM(5-10years 39.8%, OR, 2.653;95% CI, 1.778 - 3.958, & > 10 years 37%, OR, 3.606 ; 95% CI, 2.362-5.504, P<0.0001), physical inactivity(64.9%, OR, 0.5188;95% CI, 0.3727-0.7220 , P<0.0001), soft drinks occasionally (31.9%, OR, 2.253; 95% CI, 1.531-3.315, P<0.0001), habit of taking tea /coffee twice without sugar(42.3%, OR, 1.845; 95% CI, 1.094 to 3.112, P=0.0208) were significant risk factors for development of nephropathy. Metformin (47.05%), a combination of Glimepiride and Metformin (30.71%), a combination of insulin isophane and insulin regular (29.41%), teneligliptin (10.45%), insulin regular (9.80%) were the anti-diabetic medications mostly given to the T2DM patients with nephropathy. The present study revealed that the risk factors for the development of diabetic nephropathy were multiple.

scholarly journals Antipsychotics in schizophrenia: a retrospective study of drug utilization pattern in outpatient department of psychiatry at a tertiary care hospital

2017 ◽  
Vol 7 (1) ◽  
pp. 167
Author(s):  
Usharani H. Patted ◽  
Hema N. G. ◽  
Anil Kumar Mysore Nagaraj
Keyword(s):  
Side Effects ◽  
Drug Utilization ◽  
Somatoform Disorders ◽  
Tertiary Care Hospital ◽  
Burden Of Illness ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

Background: Psychiatric disorders are one of the major causes of morbidity and the burden of illness is enormous and remains grossly under represented. Psychotropic drugs have had a remarkable impact in psychiatric practice. Currently a large number of atypical antipsychotics available in the market are endorsed as better options for treating schizophrenia than the typical antipsychotics. The main objective of the study was to find the commonly prescribed antipsychotics in schizophrenia patients in a tertiary care center.Methods: After Institutional Ethics Committee approval, a retrospective cross-sectional drug utilization study of 400 prescriptions was under taken from 1st July 2015 to 30th July 2016 in the outpatient department of psychiatry of a tertiary care hospital. The prescribing pattern of antipsychotics in schizophrenia patients (N=107) was measured.Results: Out of 400 cases in the outpatient department, schizophrenia cases were predominant (N=107 i.e. 27%) out of which 42.1% were females and 57.9% were males. This was followed by mood disorders and neurotic & somatoform disorders. The most common antipsychotic used was olanzapine followed by risperidone. Least commonly used antipsychotic was haloperidol. Most of the patients who received risperidone also received an anticholinergic trihexyphenidyl (91.8%).Conclusions: Olanzapine and risperidone are the most commonly used antipsychotics. Anticholinergics should be used only in selected patients on antipsychotics as tolerance develops to extrapyramidal side effects. Anticholinergics are unnecessary after 3-6 months in all except 10% of patients. Moreover, it has its own side effects and adversely interacts with antipsychotics.

scholarly journals Prescription pattern of medicines in a tertiary care hospital: a cross-sectional study

2019 ◽  
Vol 8 (6) ◽  
pp. 1437
Author(s):  
Roshi . ◽  
Vishal R. Tandon ◽  
Brij Mohan Gupta ◽  
Sanjeev Gupta
Keyword(s):  
Treatment Failure ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Therapeutic Benefit ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Sectional Study ◽  
Prescribing Pattern ◽  
Cross Sectional

Background: Prescribing drugs for any disease is not complete until it is rationally done. Irrational prescriptions often lead to treatment failure, toxicity or drug interactions which may prove detrimental to the patient. Antibiotics are very much prescribed in day to day practice but their rational use prevents treatment failure, resistance.Methods: A cross sectional study was conducted in a tertiary care hospital to see the antibiotic prescribing pattern. Prescriptions were screened one time from different OPDs with prior permission from the doctor attending the respective OPD.Results: A total of 200 prescriptions were assessed out of which 121 had monotherapies prescribed, 79 had FDCs. Antibiotics were the most commonly prescribed drugs. Prescriptions having drug combinations were assessed and pantoprazole domperidone was the most commonly prescribed (32.91%).Conclusions: Drugs should be prescribed rationally for proper therapeutic benefit. It encourages the patient to properly use the medicine and properly comply to it.

scholarly journals Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

2019 ◽  
Vol 8 (6) ◽  
pp. 1430
Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant
Keyword(s):  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Brand Names ◽  
Outpatient Department ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.

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