Rational Use of Antibiotics and Monitoring of Drug Interactions in Patients with Respiratory Tract Infection

Abstract

Background: A respiratory tract infection (RTI) is considered as one of the commonest public health problem dealt with in primary care. Objective: To evaluate the prescribing pattern of antibiotics, drug interactions involved and their rationality in the management of respiratory tract infection. Methods: The study was conducted in 180 RTI patients admitted in Sagar Hospital, Bengaluru. The study was a prospective, observational study. The information collected was based on inpatient case record and documented in the predesigned patient profile form. The data was analyzed and assessed using Micromedex 2.0, Medscape and www.drugs.com. Results: A total of 180 patients were included as per inclusion and exclusion criteria, out of which 98(54.4%) were male and the mean (SD) age of the patients was 58(14.3) years. Majority of patients had hypertension 77(26.22%) as co-morbidity followed by diabetes mellitus 64(21.89%). Among 180 cases, 42(23.33%) cases were diagnosed with URTI in which 7(16.66%) patients had sinusitis, 5(11.9%) had tonsillitis, 8(19.04%) had common cold, 2(4.76%) had pharyngitis and 19(45.23%) had unspecified URTI. In study population 134(74.44%) cases were diagnosed with LRTI in which 7(5.22%) were acute bronchitis, 40(29.85%) were bronchitis, 2(1.49%) were broncholithiasis, 29(21.64%) were pneumonia and 56(41.80) were unspecified LRTI. 4(2.23%) cases were diagnosed with both URTI and LRTI. In current study a total of 322 Antibiotics were prescribed among which most commonly used is Piperacillin+ Tazobactam 88(27.32%) followed by Clarithromycin 52(16.14%). The most offending drug in major, moderate and minor drug interactions was clarithromycin 111(79.28%), clarithromycin 65(51.58%) and Piperacillin + Tazobactam 23(56.09%) respectively. Conclusion: This study concluded the prudent use of antibiotics will diminish the burden of multi-drug resistance and thereby providing better patient management. Key words: Respiratory tract infection, Prescribing pattern, Rational use of antibiotics, Drug interactions.