Antibiotics In Outpatient Department Research Articles

Antibiotic Use for Febrile Children in a Tertiary Care Hospital's Outpatient Department: A Cross-Sectional Study.

Background Irrational prescription of antibiotics is contributing to the antimicrobial resistance crisis in low and middle-income countries. Antibiotic stewardship programs need to be implemented to rationalize the use of antibiotics, but data on antibiotic prescriptions in pediatric outpatient departments is minimal. This study aimed to determine the frequency of antibiotic prescriptions in febrile children attending the Paediatric Outpatient Department (OPD) at Combined Military Hospital, Lahore, and observe the factors affecting the decision to prescribe antibiotics. Methodology A cross-sectional, descriptive study with non-probability sampling in the Department of Paediatrics at the Combined Military Hospital (CMH), Lahore, was conducted over two years. The confidence limit was 95%, and the anticipated population proportion was 32%. The primary outcome was the proportion of children aged two months to 10 years presenting to the OPD with fever who received antibiotics. Further analysis included the effect of patient-level risk factors on antibiotic prescription, especially in children with respiratory tract infections (RTIs). Results Of the 225 children analyzed, 137 (61%) received antibiotics. Of these antibiotic prescriptions, 123 (90%) were second-line antibiotics. Older age (odds ratio (OR) = 2.3, 1.18-4.46), high fever (OR = 2.48, 1.37-4.5), presenting in autumn and winter seasons (OR = 2.85, 1.53-5.3), ill appearance (OR = 2.71, 1.12-6.55), tachycardia (OR = 4.28, 1.22-15.01), and tachypnea (OR = 4.01, 1.14-14.12) were associated with increased likelihood of antibiotic prescription. Antibiotic prescriptions in children with RTIs were associated with lower RTI (OR = 12.96, 3.49-48.08), probable bacterial infection (OR = 12.37, 4.77-30.05), tachycardia (OR = 10.88, 1.28-92.24), tachypnea (OR = 14.73, 3.14-68.99), and increased work of breathing (OR = 7.8, 2.05-29.56). Conclusions The evidence of the widespread inappropriate use of antibiotics in OPDs, particularly for upper RTIs, highlights the need for an antibiotic stewardship program. Antibiotic overprescription promotes antibiotic resistance, prolonging illness and increasing healthcare costs.

Prescribing pattern of antibiotics in ENT outpatient department in a tertiary care teaching hospital

Background: Antibiotics are the most commonly used and misused of all drugs. Patterns of antibiotic resistance widely follows local patterns of antibiotic prescribing and usage. Periodic data collection and analysis of antibiotic prescriptions at regional level are essential to understand and combat antibiotic resistance. Objective of the study was to study the prescribing pattern of antibiotics in outpatient department of Otorhinolaryngology in a tertiary care teaching hospital. Methods: A prospective observational study of prescribing pattern of antibiotics was conducted in the department of Otorhinolaryngology. Data of antibiotic utilization in outpatient department was collected through duplicate copies of the prescriptions. The data obtained was analyzed and the conclusions were drawn using descriptive analysis.Results: A total of 606 prescriptions were collected and analyzed during the study. Average number of antibiotics prescribed per prescription was 1.24 most of the antibiotics were prescribed for a duration of 1 to 5 days. Commonly prescribed antibiotic class was penicillin (48.1%) followed by quinolone (18.3%). Most of the antibiotics were prescribed by their brand names (98.8%).Conclusions: The present study highlights the wide use of extended spectrum antibiotics, along with brand names for prescribing. Interventions for prescribing of generic drugs from the essential drug list needs to be encouraged among physicians.

Use of antibiotics for patients presenting with symptoms suggestive of upper respiratory tract infections of less than 3 days to an outpatient department of a tertiary hospital in Sri Lanka

Background: Upper respiratory tract infections (URTIs) include common cold, pharyngitis, sinusitis, tracheobronchitis and influenza. URTIs are generally due to viral infections and do not require antibiotic treatment. But unnecessary use of antibiotics for URTIs is common all over the world. Objectives: Objective of this study was to identify use of antibiotics for patients presenting with symptoms suggestive of URTI for less than 3 days to an outpatient department (OPD) of the Teaching Hospital, Karapitiya (THK), Sri Lanka. Methods: Study was conducted as a cross sectional study using an interviewer administrated questionnaire. Results: Total of 612 patients with symptoms suggestive of URIs for less than three days were included in the study, of which, 440 were prescribed antibiotics (71.90%). The most commonly used antibiotic was amoxicillin and the least commonly used antibiotic was co-amoxiclav. Percentages of antibiotic prescription were 65.1%, 76.1% and 71.4% for below 12 years, between 12 – 60 years and above 60 years age categories respectively. Patients with sore throat, hoarseness and myalgia received the highest percentage of antibiotics. Similar percentage of patients with symptoms for less than 24hrs as well as more than 48hrs were prescribed antibiotics. Conclusions: Prescription of antibiotics in OPD of THK is considerable high for URIs. Rate of antibiotics prescription reported in this study is the highest rate compared to all other studies published on antibiotic prescription for URTI.

Drug utilization patterns of antibiotics in outpatient department of educare dental hospital at Malappuram, Kerala, India

Background: Drug utilization studies aims to evaluate factors related to the prescribing, dispensing, administering and taking of medication, and its associated events. Antibiotic prescription by dental practitioners has an important impact on the rate of general antibiotic prescription use, and an attempt has been made to establish a surveillance system for the monitoring and control of the use of these drugs.Methods: Retrospective record-based study was conducted at outpatient department at Educare Dental College and Hospital, Chattipparamba, Malappuram, Kerala. About 2802 prescriptions were screened, drugs prescribed were noted, tabulated and analysed.Results: Total no. of prescriptions 2802, total no. of antibiotics prescribed 2916, average no of antibiotics per prescription 1.04. Out of antibiotics prescribed 72% were monotherapy and 28% were fixed dose combination. Among antibiotics beta lactam antibiotics were commonly prescribed followed by nitroimidazoles and macrolides.Conclusions: The study was conducted to analyze the drug utilization pattern in outpatient department at dental hospital. Most of prescription were rational, both monotherapy and polypharmacy were practiced. Safer drug with less adverse effect profile were considered. Among the antibiotic amoxicillin was the commonest.