Average Number Of Antibiotics Research Articles

Antibiotic prescribing patterns in pediatric patients using the WHO access, watch, reserve (AWaRe) classification at a quaternary hospital in Nampula, Mozambique.

Antibiotics are often prescribed inappropriately, either when they are not needed or with an unnecessarily broad spectrum of activity. This is a serious problem that can lead to the development of antimicrobial resistance (AMR). This study was conducted to assess the antibiotic prescribing pattern in pediatric patients hospitalized at a quaternary hospital in Nampula, Mozambique, using the WHO indicators and Framework as a reference. A retrospective study was conducted using secondary data obtained from medical records. The study population consisted of children aged 0-10years who were hospitalized in a quaternary-level hospital ward in Nampula, Mozambique. The pattern of antibiotic prescriptions was assessed using indicators and the WHO classification of antibiotics into AWaRe categories. Descriptive statistics were applied. A total of 464 antibiotics were prescribed during the study. The age groups of 1-3years and 28days-12months were prescribed more antibiotics. The most common antibiotics were ceftriaxone and crystallized penicillin, which were frequently prescribed for patients suffering from bronchopneumonia, gastroenteritis, and malaria. 74.8% of the antibiotics prescribed belonged to the Access group, while 23.7% belonged to the Watch group. There were no prescriptions of antibiotics from the Reserve group. The average number of antibiotics per prescription was 1.51 (SD ± 0.725). The percentage of antibiotic prescribing was 97.5%, with 96.20% by injection. All antibiotics prescribed were on the essential medicines list and prescribed by generic name. These results are concerning and highlight the urgency of strengthening antimicrobial optimization measures, as well as implementing the AWaRe framework in antibiotic prescribing as an essential strategy to combat AMR.

Assessment of the use of antibiotics based on the WHO access, watch, and reserve index in a multidisciplinary intensive care unit of a medical college in Eastern India

Background: Antibiotics are frequently prescribed to critically ill patients admitted to intensive care units (ICUs). About 30–60% of antibiotics prescribed in ICUs are unnecessary, inappropriate, or suboptimal and contribute substantially to the development of antimicrobial resistance. Aims and Objectives: The present study was undertaken to assess the use of antibiotics based on the World Health Organization (WHO) access, watch, and reserve (AWaRe) index in a multidisciplinary ICU of a medical college and hospital in Eastern India. Materials and Methods: The descriptive past record-based study was carried out among patients admitted in the multidisciplinary ICU of a medical college and hospital over 6 months. Information from the ICU bed head tickets (BHTs) was captured in a data record form and analyzed. Results: A total of 97 BHTs were reviewed, and 257 antibiotics were prescribed to 90 patients. The prevalence of antibiotic use was 92.78%. Average number of antibiotics per patient was 2.85. In most instances (88.89%, 80), either two (28.88%), three (27.77%), or even four (20%) antibiotics were used. Frequency of use of AWaRe antibiotics was 21.43% (51/238), 67.23% (160/238), and 11.34% (27/238), respectively. Meropenem (15.12%, 36), piperacillin-tazobactam (36, 15.12%), and ceftriaxone (35, 14.70%) were the three most frequently prescribed watch group antibiotics. Most antibiotics were used empirically (60%), and 40% (36/90) use was targeted. Conclusion: Empirical treatment with antibiotics is common in ICUs. The WHO AWaRe tool may check the injudicious and unnecessary use of antibiotics and thus promotes the rational use of antibiotics and prevent the development of antibiotic resistance in ICUs.

Assessment of Antimicrobial Utilization Pattern using World Health Organization Indicators in a Tertiary Care Hospital: A Cross-sectional Study

ABSTRACT Objectives: The aim of the study was to analyze the antimicrobial utilization pattern using the World Health Organization (WHO) indicators with the ultimate goal of ensuring rational drug use to evaluate the policies and procedures in the hospital for the appropriate use of antimicrobials using hospital indicators and prescribing indicators. Materials and Methods: A prospective, cross-sectional study was conducted in a tertiary care hospital in the southern part of India, where data from the pharmacy section and 125 patient records each from general medicine, surgery, and intensive care unit patients were taken. Antimicrobials’ prescription and utilization patterns in tertiary care were analyzed using the WHO hospital and prescribing indicators. Results: The hospital indicators were up to the expected level of the WHO standards with standard treatment guidelines (STGs), hospital formulary, and the critical list of antimicrobials available on the assessment day. None of the antibiotics were out of stock during the study period. Around 55.4% of admitted patients were prescribed antibiotics in the prescribing indicators, with the average number of antibiotics per patient being 1.591. With almost 99.7% of antibiotics are prescribed from the hospital formulary list and around 3003.7 INR as the average cost per hospitalization. The average duration of treatment was 4.96 days, with 74.3% of pneumonia patients treated according to the STG. The antimicrobials prescribed with the generic name were only 17.58%. Conclusions: The prescribing pattern of antimicrobial agents in our study site was satisfactory in hospital indicators but less than optimal in a few prescribing indicators, indicating the need for the root cause analysis for less than optimum results.

Prescribing pattern of antibiotics by family physicians in primary health care

PurposeIrrational prescription of antibiotics is an ongoing global public health concern, leading to antibiotic resistance. Understanding the prescribing pattern of antibiotics is important to tackling mal-prescription and antibiotic resistance. We aimed to investigate the pattern and factors affecting outpatients’ antibiotic prescribing by family physicians in Primary Health Care (PHC).MethodsA cross-sectional study was conducted in 19 PHC facilities in Alborz province. Prescribing pattern of antibiotics was evaluated among 1068 prescriptions by family physicians. Prescribing pattern of antibiotics included prescriptions containing antibiotics, the number of antibiotics per prescription, type, name of antibiotic, and mal-prescription. Multiple logistic regression analysis was used to estimate the adjusted odds ratios and 95% confidence intervals.ResultsOverall, 57% of the prescriptions had ≥ 1 antibiotic and the average number of antibiotics per prescription was 1.27. Amoxicillin was the commonly prescribed antibiotic. There was a significant relationship between age, sex, type of health insurance, work experience of the physician, and seasons with antibiotic prescribing (P < 0.05). In 59.31% of antibiotic prescriptions at least one of the scientific criteria was not fulfilled. In the final analysis, after adjusting for the potential confounders, field experts of physicians (OR = 1.59; 95% CI: 1.08–6.17), female sex (OR = 2.23; 95% CI: 1.18–4.21), and winter season (OR = 3.34; 95% CI: 1.26–8.15) were found associated factors with antibiotic prescribing.ConclusionThe average number of antibiotics per prescription and the percentage of irrational prescriptions were relatively high in this study. There is need to improve antibiotic prescribing patterns among family physicians working in primary health care.

Gender-based analysis of antibiotic prescribing trends for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore

Respiratory tract infections (RTIs), caused by microorganisms such as bacteria and viruses, are a leading cause of morbidity and mortality in children worldwide. Antibiotic resistance is a serious concern, and proper prescribing practices are necessary to avoid life-threatening situations. Thus, this study aims to conduct a gender-based analysis and compare antibiotic prescribing patterns for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore. This comparative cross-sectional study was conducted at Children’s Hospital in Lahore, Pakistan, for three months and enrolled 250 pediatric patients who met the inclusion criteria, including 155 males and 95 females. Data were collected through face-to-face interviews and reviewing hospital records. The results of the study showed that the average number of drugs per prescription was 3.06 ± 1.29 (male) and 3.12 ± 1.5 (female), while the average number of antibiotics per prescription was 2.25 ± 0.60 (male) and 2.17 ± 0.58 (female). The most prevalent medical conditions were bronchopneumonia (53.55% males and 58.95% females), followed by respiratory distress (20.00% males) and pneumonia (16.13% males and 16.84% females). The most commonly prescribed drugs were J01DD04: Ceftriaxone (78.71% males and 71.58% females), J01CR02: Amoxicillin/Clavulanate (59.35% males and 56.84% females), and J01GB06: Amikacin (41.29% males and 45.26% females). A low percentage of prescriptions had major drug-drug interactions (8.39% males and 10.53% females), while most prescriptions had no drug-drug interactions (81.94% males and 84.21% females). There was no significant difference between male and female patients for caregiver, indications for antibiotic prescriptions, the class of active agent prescribed, and drug interactions. Our study findings indicate that most male and female patients admitted to the hospital with lower respiratory tract infections were prescribed antibiotics alongside analgesics and antipyretics. Furthermore, our analysis revealed minimal drug interactions among the prescribed medications. Importantly, we observed a similar antibiotic prescribing trend among male and female pediatric patients, highlighting the consistency in treatment approaches.

Impact of antibiotic therapy management by clinical pharmacists on rational drug use in the perioperative period of retinal detachment surgery in china: a retrospective study from the perspective of prescription structure

Background This paper aims to assess the impact of antibiotic therapy management by clinical pharmacists on rational drug use (RDU) in the perioperative period of patients receiving retinal detachment surgery in China from the perspective of prescription structure. Methods: In this study, a retrospective study was used to compare the differences in the RDU between 233 patients (the experimental group) receiving medical treatment and 210 patients (the control group) without clinical pharmacist intervention. The data were collected with a set of indicators adjusted from the core medication use indicator proposed by the World Health Organization and the International Network of Rational Use of Drugs according to the background of China. Results: There were significant differences in average number of drugs per prescription (19.7 and 20.8, P = 0.001), percentage of drugs on the reimbursable list (98.32% and 72.4%, P = 0.003), and average treatment expenditure per prescription (555.3 yuan and 707 yuan) between the experimental group and the controlled group, while average number of antibiotics per prescription (4.2 and 4.3, P = 0.114), average number of injections per prescription (12.02 to 11.96, P = 0.804) were not changed significantly. Conclusions: More efforts are needed to improve the effectiveness of the antibiotic therapy management by clinical pharmacist on rational drug use, meanwhile the objective of cost-saving should be included in the service pattern of clinical pharmacy services.

TRENDS IN PRESCRIPTION PATTERN IN MEDICAL INDIAN ICU AND IT’S IMPACT ON PATIENT OUTCOME

Objective: The objective of this study is to evaluate the trends in prescribing pattern in medical ICU concerning patient age, gender, past, and current illness along with comorbidities for the evasion of polypharmacy and to improve patient outcomes. Methods: A prospective analysis of the case records of patients admitted to the ICU of Yashoda hospital in India was carried out. Results: 120 patients were evaluated, consisting of 77% male patients. The mean±SD of age is 53.81±14.63. The majority of the study subjects belonged to the age group of 50-67 y (32%) Most common causes for admission to the ICU were Respiratory diseases and Stroke. Diabetes mellitus and Hypertension are the most common co-morbidities identified. The total number of drugs used were 1502 during this study period. The average number of drugs per prescription is 12. The range is between 2-30. The average number of antibiotics per prescription is 3. Commonly prescribed drug classes were the GI agents in 100% of patients, followed by antimicrobial agents (AMAs) in 95.8% of patients. About 42.5% of patients received 3 antibiotics per day. 55 potential drug-drug interactions were interpreted in 46 patients. 30(55%) were moderate interactions 25(45%) were major interactions, which were addressed. De-escalation of antibiotics was seen in 29% of patients while escalation in 13%. The death rate is only 5% in our ICU setting. Conclusion: This prescription pattern study can provide a framework for continuous prescription audit in the ICU

Antibiotic Prescribing Practices in Primary Care Settings Using 2019 WHO AWaRe Framework

Background: Bacteria have ability to rapidly evolve, develop strategies to resist antibiotics, and reduce the effectiveness of antibiotics. The emergence and spread of antimicrobial resistance is an important global public health challenge to tackle. Studying antibiotic prescribing practices would allow rational use and preserve effectiveness of antibiotics.&#x0D; Objective: To study prescribing practices of antibiotics in out-patients in primary care settings using the WHO AWaRe framework.&#x0D; Methodology: A prospective cross-sectional study was conducted to evaluate prescribing practices of antibiotics in the primary care facility of three private hospitals using the WHO ‘core prescribing indicators’ and Access, Watch, and Reserve (AWaRe) classification. A systematic sampling technique was employed to collect the prescriptions at each hospital for three months. Descriptive statistics were applied to the collected data.&#x0D; Results: A total of 2685 prescriptions were systematically evaluated. 1280 encounters had at least one antibiotic (47.7%), of which 1041 consist of only one antibiotic (81.5%). Among 1280 antibiotic encounters, the average number of antibiotics per encounter was 1.2 and 14.6% were prescribed with a parenteral antibiotic. 26.6% and 78.6% antibiotics were prescribed using generic names and from the WHO Essential Medicines List, respectively. Amoxicillin/clavulanic acid, ceftriaxone, azithromycin, cefoperazone, and amoxicillin were the five most commonly prescribed antibiotics. According to the WHO AWaRe classification, a total of 27 specific antibiotics (Access 11, Watch 14, and Reserve 2) were prescribed. 38.4%, 53.7%, 0.3%, and 10.5% of antibiotics prescribed were from the ‘Access’, ‘Watch’, ‘Reserve’, and ‘Not Recommended’ categories, respectively. Third generation cephalosporins (24.0%) were prescribed in high rate among ‘Watch’ category. The most commonly prescribed ‘Access’ and ‘Watch’ antibiotics were amoxicillin/clavulanic acid (12.5%) and ceftriaxone (10.6%), respectively. Amoxicillin index was 19.5% and ‘Access-to-Watch’ index was 0.76, which were below the priority values.&#x0D; Conclusion: Except few indicators, still better prescribing practices of antibiotics are needed to fully meet the WHO recommendations. Antibiotic prescribing guidelines as per the WHO AWaRe framework, changes in prescription patterns and preference of “Access” over ‘Watch’ antibiotics are crucial to preserve effectiveness and promote rational use of antibiotics.

Analysis of prescriptions for completeness in a tertiary care teaching hospital

Background: Prescribing errors are major problems among medication errors. Prescribing errors include mistakes or inaccuracies when choosing and ordering treatments, such as wrong doses or illegible prescriptions. Most of these errors result in no harm or have low to moderate harm however, some result in severe harm or death. There are economic consequences attributed to prescribing errors.Methods: The aim of the study was to analyse the prescriptions for completeness. The prospective observational study was conducted in outpatient department of different specialities in a tertiary care teaching hospital. Prescriptions with atleast one antibiotic, was collected through duplicate copies from the prescribing doctors. The data obtained from prescriptions were analysed and the conclusions were drawn using descriptive analysis.Results: A total of 1516 prescriptions with 3957 drugs were prescribed, out of which 1697 were antibiotics. Average number of drugs per prescription was 2.6 and average number of antibiotics per prescription was 1.1. Patient’s name, age, and gender were mentioned in 99%, 87.8%, and 96% of prescriptions respectively. Generic drug names were used in 0.7% of prescriptions. Out of 1681 antibiotics prescribed in 1574 had appropriate dosage form.Conclusions: The present study highlights the problem of incomplete prescriptions and extensive use of brand names. Intervention strategies focused on education and training, introduction of strict feedback control and monitoring systems are highly effective in reducing prescription errors.

Identifying Antibiotic Prescribing Patterns Through Multi-Level Latent Profile Analyses: A Cross-Sectional Survey of Primary Care Physicians.

Background: Overuse of antibiotics significantly fuels the development of Antimicrobial resistance, which threating the global population health. Great variations existed in antibiotic prescribing practices among physicians, indicating improvement potential for rational use of antibiotics. This study aims to identify antibiotic prescribing patterns of primary care physicians and potential determinants. Methods: A cross-sectional survey was conducted on 551 physicians from 67 primary care facilities in Hubei selected through random cluster sampling, tapping into their knowledge, attitudes and prescribing practices toward antibiotics. Prescriptions (n = 501,072) made by the participants from 1 January to March 31, 2018 were extracted from the medical records system. Seven indicators were calculated for each prescriber: average number of medicines per prescription, average number of antibiotics per prescription, percentage of prescriptions containing antibiotics, percentage of antibiotic prescriptions containing broad-spectrum antibiotics, percentage of antibiotic prescriptions containing parenteral administered antibiotics, percentage of antibiotic prescriptions containing restricted antibiotics, and percentage of antibiotic prescriptions containing antibiotics included in the WHO “Watch and Reserve” list. Two-level latent profile analyses were performed to identify the antibiotic prescribing patterns of physicians based on those indicators. Multi-nominal logistic regression models were established to identify determinants with the antibiotic prescribing patterns. Results: On average, each primary care physician issued 909 (ranging from 100 to 11,941 with a median of 474) prescriptions over the study period. The mean percentage of prescriptions containing antibiotics issued by the physicians reached 52.19% (SD = 17.20%). Of those antibiotic prescriptions, an average of 82.29% (SD = 15.83%) contained broad-spectrum antibiotics; 71.92% (SD = 21.42%) contained parenteral administered antibiotics; 23.52% (SD = 19.12%) contained antibiotics restricted by the regional government; and 67.74% (SD = 20.98%) contained antibiotics listed in the WHO “Watch and Reserve” list. About 28.49% of the prescribers were identified as low antibiotic users, compared with 51.18% medium users and 20.33% high users. Higher use of antibiotics was associated with insufficient knowledge, indifference to changes, complacency with satisfied patients, low household income and rural location of the prescribers. Conclusion: Great variation in antibiotic prescribing patterns exists among primary care physicians in Hubei of China. High use of antibiotics is not only associated with knowledge shortfalls but also low socioeconomic status of prescribers.

Evaluation of Antibiotic Prescription and Utilization amongst Hospitalized Children in a Tertiary Facility in Sokoto, North-Western Nigeria

Background: Antibiotics are the most widely utilized therapeutic agents. Inappropriate use causes increase cost and antibiotic resistance. The World Health Organization recommends assessment of antibiotics use to guide prescribing practices.&#x0D; Objective: To describe the pattern of antibiotic usage among paediatric inpatients aged &gt; 1 month to 15 years in a tertiary hospital in Sokoto, Nigeria.&#x0D; Methods: Febrile children were recruited prospectively by systematic random sampling from January to October 2018. Socio-demographics, diagnosis, antibiotics administered were obtained from case notes. The WHO indicators of use of antibiotics were employed for evaluation. Data was analysed with SPSS version 23.&#x0D; Results: Out of 352 children, 318 (90.3%) received antibiotics; commonest being Ceftriaxone in 155/318 (48.7%), Cefuroxime in 74 (23.2%), and Metronidazole in 29 (9.1%). Average number of antibiotics per patient was 2.3±1.1 with treatment duration of 4.3±1.4days. Antibiotic consumption was 937.2 days of antibiotic therapy/1000 patient days (DOT/PD). Generic name was used in 92.3% while 100% of the drugs were on the essential medicine list. Frequent diagnoses were severe malaria 98/352 (27.8%), respiratory infections 39 (11.1%) and severe malnutrition in 38 (10.8%). Only 6 (1.7%) patients had microbiologic evidence of infection.&#x0D; Conclusion: Utilization of antibiotics is higher than recommended. There is need for improved diagnostic facilities to avoid antibiotic overuse and its consequences.&#x0D; Keywords: antibiotics, prescription, utilization, children, inpatients, DOT

A retrospective study of antimicrobial usage in wound healing

Background: Chronic wounds are responsible for increase in burden to healthcare systems. The evidence concerning effectiveness of antibiotic therapy or optimal regimens is insufficient. Patients with chronic wounds receive significantly more systemic and topical antibiotics. Current guidelines for antibiotic prescribing for such wounds are often based on expert opinion rather than scientific fact. As there is increasing prevalence of antibiotic resistance, the relationships between antibiotic resistance and rationales for antibiotic therapy have to be determined. Current practice of antibiotic usage for chronic wounds and postoperative wounds in a tertiary care setting should be studied.Methods: Retrospective study was conducted from February 2017 to February 2018 using medical records of patients with wound admitted in surgical departments in HIMS, Hassan, Karnataka. The inpatient records were analysed, which includes duration of stay in the hospital, number of drugs/products per person, percentage of antibiotics prescribed, percentage of antibiotic injection prescribed, and other modalities used to treat wounds.Results: In present study, amongst 100 antimicrobial prescriptions, 26 females and 74 males. The most commonly prescribed parenteral antibiotic was ceftriaxone (58%), followed by metronidazole (56%). The average number of antibiotics per prescription was 2.8. The mean duration parenteral antibiotics given was 4.26 days during their hospital stay oral antibiotics were 5.18 days after the discharge from the hospital.Conclusions: The information generated shall be used to decide the policies to govern the prescription of antibiotics in the management of chronic wounds and post-operative wounds.

THE MAGNITUDE OF PRESCRIBED ANTIBIOTICS IN PEDIATRIC EMERGENCY DEPARTMENT IN BASRA HOSPITAL FOR MATERNITY AND CHILDREN

Introduction: Antimicrobial agents are common employ in paediatric patients. Emergency department make good place for known prescribing pattern of antibiotics with frequent use for disease that interfere in treatment between private pharmacy &amp; hospital. The irrational and overuse of antibiotic in last decades did not follow the international guidelines and infectious strategy which if not controlled or minimize will lead to higher rates of mortality in human societies. The aim was to find the magnitude of antibiotics prescribing in children internal emergency department at Basra hospital for Maternity and Children &amp; showing relationship with misuse of it Methods: The study was performed on 560 paediatrics patients aged (1 month -13 years) that seen in the (Basra Hospital for Maternity and Children) emergency department during 4 months from December 2017 to March 2018. These cases were dividing according to containment antibiotic and several parameters such as patient diagnosis and number of antibiotics prescribed. Results: A total of 61% (n=342) patients were males. The average number of antibiotics per patient was 1.45 Prescription did not contain antibiotics 28.57% (n=160) Prescription contain antibiotics 71.42% (n =400) of all patient from total prescribed. Most cases diagnosis for prescribing antibiotics are (24%) Gastroenteritis (16.25%) bronchiolitis and (11.75%) pneumonia. Conclusion: The dispensing of antibiotics is not following constant or international guidelines which will cause problems like resistance and economic side also. Nearly almost the admitted patients received antibiotics regardless the culture results.

Prescription of antibiotics among paediatric outpatients at Teaching Hospital-Jaffna

Aim of the study was to evaluate prescription of antibiotics among paediatric outpatients at Teaching Hospital-Jaffna.It was a cross sectional descriptive study carried out among the paediatric outpatients in July and August 2014. A data extraction form was developed based on WHO data collection forms and was used to collect the data. Nine drug use indicators which include modified core and complementary WHO drug use indicators and indicators developed by the investigators were used to evaluate antibiotic prescription. Descriptive statistics were used for data analysis.Out of 1181 prescriptions of paediatric outpatients, 825 (69.9%) had antibiotics. Average number of antibiotics per prescription was 0.7. Percentage of antibiotics prescribed by generic name, from essential medicine list and for common conditions were 97%, 100% and 91.4% respectively. Percentage of prescriptions with the documentation of reason for prescribing an antibiotic was 97%. Only 3.4% antibiotic prescriptions were complete. Percentage of drug cost spent on antibiotics was 33.2% and average antibiotic cost per encounter was 54.34 Sri Lankan rupees. The most frequently prescribed antibiotic group was penicillins (53.3%). The most common indication for antibiotics was respiratory tract infection (70.3%). Majority of the antibiotics (74%) were prescribed in paediatric dosage form.Good prescribing practice was observed for prescribing in generic name, prescribing the antibiotic from essential medicines list, prescribing for common conditions, documentation of reason for prescribing and prescription of paediatric dosage forms. The completeness of antibiotic prescriptions was poor and needs special attention to improve. The drug use indicators are useful tools to evaluate the antibiotic prescriptions in a setting as well as among different settings.

ANTIBIOTIC UTILIZATION IN PEDIATRIC IN-PATIENTS AT A TERTIARY CARE UNIT.

Objectives: Antibiotics are key drugs which are used for the treatment of infectious disease and are among the drug that are most frequently prescribe in pediatric patients. This study was designed to assess antibiotics utilization patterns in pediatric ward of a tertiary care teaching unit, Peshawar. Study Design: A retrospective cross sectional study. Setting: Pediatric ward by evaluating antibiotics utilization patterns in pediatric ward of a tertiary care teaching unite, Peshawar. Period: January, 2017 up to March, 2017. Method: Results: There were 219 patients included in the study. In this study, the major medical conditions for which antibiotics were prescribed include pneumonia (23.28%). The most commonly used antibiotics were ceftriaxone, 46.21%, while the most commonly prescribed multiple antibiotics were ceftriaxone plus ampicillin (21.9%) followed by Ceftriaxone &amp; Metronidazole. The average number of antibiotics per prescription was 1.75. At least 114 (52%) patients were prescribed with single antibiotic and patients prescribed with two antibiotics were 72 (32%). There was a high rate of parental administration which account for about 92.26% of the total antibiotic prescribed. It is assessed that 26.89% of total drugs were prescribed by generic name which were extremely lesser than the medication prescribed with brand names 73.10%. Conclusion: From the result we concluded that third generation cephalosporin especially ceftriaxone was most frequently prescribed antibiotic in hospitalized children.

An analysis on rational use and affordability of medicine after the implementation of National Essential Medicines Policy and Zero Mark-up Policy in Hangzhou, China.

BackgroundThe National Essential Medicine Policy and the Zero Mark-up Policy was introduced to improve the rational use and affordability of medicine. This study analyzed the changes of medicine use at different Health Care Institutions in Hangzhou city after the implementation of National Essential Medicine Policy and the Zero Mark-up Policy.MethodsFacility based survey was conducted in 17 Health Care Institutions and 16406 outpatient prescriptions in 2011 and 2013 were collected. Average number of medicines, average number of antibiotics and average expenditure per prescription were analyzed. Comparisons between 2011 and 2013, among different levels of Health Care Institutions and age groups were conducted.ResultsThe average number of medicines per prescription, use of antibiotics, intramuscular (IM) injections and intravenous (IV) injections decreased while the use of hormones increased. No significant change of the average medicine expenditure per prescription was observed. Disparities among different levels of Health Care Institutions and different age groups existed.ConclusionThe problems of poly-pharmacy, overuse of antibiotics, intramuscular (IM) injections and intravenous (IV) injections and hormones still existed, however mitigated after the implementation of The National Essential Medicine Policy and the Zero Mark-up Policy.

Drug utilization study of antibiotics in infectious diseases in a tertiary care hospital

Background: Infectious diseases represent a major cause of mortality and morbidity in India. Irrational use of antibiotics can cause increase adverse drug reaction, leading to antibiotic resistance and increase in the treatment cost. Hence pattern of use of antibiotics need to be studied, therefore the aim of our study is to observe the antibiotics prescription pattern and drug utilization in department of medicine indoor patients at our tertiary care hospital.Methods: This was a prospective observational study carried out among indoor patients admitted in medicine ward and was conducted between January 2018 to March 2018 in Basaveshwara Teaching and General Hospital attached to M.R. Medical College, Kalaburagi. The data that was obtained was analysed and presented as percentages using descriptive statistics.Results: 100 patients were enrolled. The main reasons for admission were for diagnosis of respiratory tract infection (36%), GIT disorders (24%), Zoonotic disease (10%), Urinary tract infection (19%) and viral fever (11%). Most common antibiotic prescribed was ceftriaxone (40%), followed by piperacillin (26%). Average number of antibiotics per prescription was 1.7.Conclusions: For a wide spectrum of clinical diagnoses variety of drugs were utilized from various drug classes. Results showed that Cephalosporin was extensively used. As antibiotics are most commonly prescribed drugs and report of misuse is not uncommon so proper strategy like educational intervention and antibiotic policy are necessary to control this.

An analysis of prescription pattern of antibiotics in infectious diseases in the ophthalmology outpatient department at tertiary care hospital

Background: In ophthalmology practice, rational prescribing plays a crucial role in reducing ocular disease burden. There is an increase in resistance and limited availability of newer antimicrobial agents, there is a need of vigilant surveillance. Aims and Objectives: This study aims to analyze the prescription of antibiotics used for infectious diseases in ophthalmology outpatient department (OPD). Materials and Methods: After taking approval from the Institutional Ethics Committee, a prospective observational study was conducted in the OPD of ophthalmology at tertiary care hospital, Vijaynagar Institute of Medical Sciences, Ballari, for a period of 4 months (October 2018–January 2019). Prescriptions of 900 patients treated during the study period were audited prospectively using a specially designed case recording form and details of prescribed drugs were recorded. Data were analyzed using descriptive statistics. Results: Majority of the patients belong to the age group of 31–60 years with male preponderance (58%). Total drugs prescribed were 2360 in that antibiotics were 1400, with an average number of antibiotics per prescription being 1.55. The most common disorders diagnosed were conjunctivitis (34%) followed by dacryocystitis, blepharitis, and others. Eye drops being the most commonly (69%) prescribed dosage form. Prescription of antibiotics showed that fluoroquinolones (87%) were most commonly prescribed followed by aminoglycosides (21%) and β-lactam antibiotics (28%). Among them, gatifloxacin (27%) was most common followed by ciprofloxacin (21%), ofloxacin, moxifloxacin, tobramycin and chloramphenicol, and others. About 70% of antibiotics prescribed from the WHO Essential Medicines List-2017 list and 59% were from National List of Essential Medicines-2015 and two-drug therapy (44%) was used commonly prescribed. Conclusion: Although the prescription errors were less, there is a lack of use of generic names. Polypharmacy was not common in the department. In an era of rapidly developing antibiotic resistance, our findings may help to improve the practice of rational drug prescription and patient care.

Prescription analysis based on the World Health Organization core prescribing indicators in pediatric population having respiratory tract infections

Background: Data regarding local drug prescribing are scarce, especially in pediatric population. Evaluation of prescriptions will be helpful in promoting rational prescribing, minimizing adverse effects and should also provide cost-effective care. Aims and Objectives: The objectives of this study were as follows: (i) To analyze the prescriptions based on the World Health Organization (WHO) core prescribing indicators and (ii) to suggest modifications, if necessary in prescribing patterns. Materials and Methods: A prospective and observational study was conducted for a period of 1 year after obtaining institutional ethical committee approval. A total of 210 prescriptions of children aged 0–18 years were analyzed according to the WHO prescribing indicators. Results: Average number of drugs prescribed per prescription was 1.89 and average number of antibiotics prescribed per prescription was 0.70. About 23.80% of drugs were prescribed by generic name. About 18.09% of drugs were given through injectable route. All drugs (100%) were prescribed from the National List of Essential Medicines, 2015. About 87.89% of children received monotherapy (single antibiotic), whereas polytherapy (more than one antibiotic) was prescribed only in 12.11% of the prescriptions analyzed. Conclusion: This study indicates that prescriptions in pediatric population having respiratory tract infections were found to be in accordance with the WHO indicators. However, there is under usage of generic drugs.

ANTIBIOTIC USE IN PEDIATRIC INFECTIONS; A STUDY IN TERTIARY CARE HOSPITAL

Objectives: Antibiotics are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in south India, to make a profile of antibiotics use and suspected adverse drug reactions (ADRs) owing to them. Methods: Hospitalized children of either sex, aged between 1 month and 12 years, were inspected. Baseline demographic and clinical features, duration of hospital stay, antibiotics received in hospital along with dosing and indications and interest of suspected ADRs attributable to their use were recorded. Every patient was followed up till discharge, admission to the Pediatric Intensive Care Unit, or passing. Results: Over the year and a half report period 364 confirmations were screened. The prevalence of Antibiotics use was 80.22%. The majority of the 292 children who received Antibiotics were males (63.35%). Median age was 35 months, five children died. In most instances, either two (41%) or a single antibiotic (37.32%) was used. Ceftriaxone, co-amoxiclav, amikacin, vancomycin, and ampicillin were predominantly used. Antimalarials, antivirals and antiprotozoals were used occasionally. Average number of Antibiotics per patient was 2.2 ± 1.1 the majority (81.15%) were by parenteral route and initial choice was usually empirical. Prescriptions were usually in generic name. The antibiotic treatment went somewhere in the range of 1 and 32 days, with a middle of 8 days. Five ADRs were noted of which half were skin rash and the rest loose stools. Conclusions: The profile of Antibiotic utilize is comprehensively like prior Indian investigations. Apparent overuse of multiple Antibiotics per prescription and the parenteral route requires exploration. Antibiotics are being used empirically in the absence of policy. ADRs to Antibiotics are occasional and usually mild. The benchmark information can serve in situation analysis for antibiotic prescribing guidelines.&#x0D; Keywords: Antibiotic; Pediatric infections; Adverse drug reactions; Tertiary care hospital.