Abstract
The objective of this research is to study the pattern of antimicrobial prescription in outpatient (OPD) and inpatient (IPD) of the Department of Otolaryngology in a tertiary care teaching hospital of North India. This was a prospective study conducted at the Teerthanker Mahaveer Medical College and Research Centre, over a period of 12 months. All the patients who attended the Ear Nose and Throat (ENT) OPD and IPD were included. The results show that out of 4800 patients, only 54% (n=2600) of patients were included in the study on the basis of inclusion and exclusion criteria and 31.25 % (n=1500) were defaulters. Majority of the patients were male 60% (n = 1560). Majority of the patients had suffered from ear disorders, 55% (n=1430). The most frequently prescribed antibacterials were β-Lactams (75.68%) followed by aminoglycosides (9.43%). Among the penicillin group, the commonest drug prescribed was a combination of amoxicillin and clavulanic acid (9.58%), in cephalosporins was cefixime (37.98%) and in aminoglycosides was gentamicin (6.25%). In the concomitant medications antihistaminic were prescribed in 11.53%, proton pump inhibitors in 20.38% cases and NSAIDS in 7.26% cases. The average number of drugs used in each prescription was 2.70. All the drugs were prescribed with trade names. The average cost per prescription per day in OPD and IPD patients were Rs.45 and Rs.185, respectively. Out of 2600 patients; culture sensitivity tests were performed for only 71 patients (inclusive of OPD and IPD). Of which only 43 patients depicted a positive culture sensitivity tests. Our study showed that antimicrobials were mostly prescribed in patients of ear diseases while it was least in throat disorders. Proton pump inhibitors were the most common concomitant drug used. The cost of treatment in IPD patients were 4.11 times more than the OPD patients. Key words: Antibacterial agents, drug utilization, ear nose and throat (ENT) infections, prescribing pattern, pharmacoepidemiology.
Highlights
Drug utilization research was defined by World Health Organization (WHO) in 1977 as “the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences” (WHO Expert Committee, 1977).The principal aim of drug utilization studies is to facilitate rational use of drugs in populations
The objective of this research is to study the pattern of antimicrobial prescription in outpatient (OPD) and inpatient (IPD) of the Department of Otolaryngology in a tertiary care teaching hospital of North India
Antimicrobial therapy were most commonly instituted in ear diseases (67.93), followed by nose (17.06) and throat (15.00%), respectively (Table 2). -lactam antibiotics were most commonly used in ear disorders (57.51) and least in throat (5.83%) (Table 2)
Summary
Drug utilization research was defined by World Health Organization (WHO) in 1977 as “the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences” (WHO Expert Committee, 1977).The principal aim of drug utilization studies is to facilitate rational use of drugs in populations. Inappropriate drug use may lead to increased effects and patient mortality (Einarson, 2008). Nose and throat (ENT) affect the functioning of adults as well as children, often with significant morbidity causing impairment of routine life of affected patients (Grace and Bussmann, 2006). It has been envisaged that with increase in global population, infections remain the most important cause of disease, with upper respiratory tract infections (URTIs) causing hearing loss especially in children. In its World Health Report of 2004, the World Health Organization (WHO 2004) estimated that respiratory infections generated 94.6 disability adjusted life years lost worldwide and were the fourth major cause of mortality, responsible for 4 million deaths or 6.9% of global number of deaths in 2002
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