Prospective Study of Antibiotics Utilization in Multi-speciality hospitals in Narasaraopet at Guntur District, Andhra Pradesh

 

Ch. Sunil Kumar1*, A. Pasupathi2

1Research Scholar, Vinayaka Missions Research Foundation, Salem, Tamilnadu, India - 636008.

2Professor, Department of Pharmaceutics, Vinayaka Missions College of Pharmacy,
Vinayaka Missions Research Foundation, Salem, Tamilnadu, India- 636008.

*Corresponding Author E-mail: sunilchavala07@gmail.com

 

ABSTRACT:

Drug use is a complex process uncertainties in diagnosis, treatment and medication adherence contribute to wide variations in the way drugs are used for any given conditions. In any country, a large number of sociocultural factors also contribute to the way drugs are used. In India, this include national drug policy, illiteracy, poverty, use of multiple health care systems, drug advertising and promotion, same of prescription drugs without prescription, competition in the medical and pharmaceutical marketplace and limited availability of and unbiased drug information. The complexity of drug use means that optimal benefits of drug therapy in patient care may not be achieved because of under use, over use or misuse of drugs. One method to evaluate and improved drug use is conducting drug use evaluation studies. Method: This study was prospective observational study in multi-specialty hospitals in Narasaraopet at Guntur district Andhra Pradesh Results: The study was conducted from August 2018 to Dec 2019 in various multi-specialty hospitals in Narasaraopet at Guntur district Andhra Pradesh. Total three departments we collected data Pediatrics, orthopedic, gynecology A total of 435 patients were participated in the current study out of 153 (35%) were males and 282 (65%) were females. In this study most common group antibiotics is cephalosporin’s 152 (34.9%) out of 435 of which mostly cefitriaxone are most commonly prescribed 70 (46%) Conclusion: Study provides the information about the prospective study of antibiotics utilization in multi-specialty hospital. It has helped to identify irrational prescribing patterns of drugs in various departments like pediatrics, gynaecology orthopedic.

 

KEYWORDS: Antimicrobial resistance, Drug information, Diagnosis, treatment.

 

 


INTRODUCTION:

Antibiotic is a chemical compound that inhibits the growth of microorganism, such as Bacteria, fungi, or protozoans.it also includes any agent with biological activity against living organisms, however, the term is commonly used to refer to substances with anti-bacterial, anti-fungal or anti-parasitical activity. The antibiotic properties of penicillium spp. Were first described in France by Ernest duchense in 1897. However, his work went by without much notice from the scientific community until Alexander Fleming's discovery of pencillins.

 

Modern research on antibiotic therapy began in Germany with the development of the narrow- spectrum antibiotic salvarsan by Paul Ehrilich in 1909, for the first time allowing an efficient treatment of the then - widespread problem of syphilis. The drug which was also effective against other spirichaetal infections, is no longer in use modern medicine.

 

Drug use evaluation (DUE) is an ongoing, authorized and systematic quality improvement process, which is designed to; Review drug use and/or prescribing factors. Provide feedback of results to clinicians and other relevant groups. Develop criteria and standards which describe optimal drug use. Promote appropriate drug use through education and other interventions Drug use/usage/utilization evaluation (DUE) was originally known as drug utilization review (DUR) in the 1970s and early 80s the terms drug utilization review and use drug evaluation are inter changeable. Medication use evaluation is another term that is used in place of due by some authors since 1994. According to the world health organization (WHO), MUE is similar to DUE in all respects except that it is patient outcome oriented and places emphasis on assessing clinical outcomes. MUE mainly aims at assessing and improving patient outcomes and there by improving the individual patients health related quality of life (HRQOL). Regardless of the terminology the main of DUE studies is to promote rational drug use.

 

Aim and objectives: The main aim of the present study was Drug utilization of the various hospitals and also main objectives shows that improving the rationality of the drugs, improving the Socio–economic status of patients.

 

METHODOLOGY:

This study was prospective observational study, its shows that Patients with age group of 5-70 years are inclusive criteria and above 70 years and ICU patients were excluded.

 

Table 1: Gender Distribution

 

Number

Percentage

Males

153

35%

Females

282

65%

Total

435

 

Figure 1: Gender Distribution

 

RESULTS AND DISCUSSION:

A total number of 435 peoples were involved in the study. Out of 153 were males and 282 were females. The gender distribution of patients enrolled for the study was presented in Table -1, Figure -1.

 

Table -2 Based on age group total prescriptions - 435 Males were 153 Females were 282 shown in Table -2 Figure -2

S. No

Age Group

No. of Male Patients

No. of Female Patients

1

0-20

85

127

2

21-40

20

115

3

41-60

25

25

4

61-70

23

15

 

Figure -2 Age distribution

 

Table 3: Total 435 Patients undergone the various kind of departments study was presented in Table -3 and Figure -3

Type of Ward

No. of Patients

%

Orthopedics

150

35%

Gynecology

145

33%

Pediatric

140

32%

 

Figure -3


 

Table -4: Total 2228 Number of dosages forms used in this three departments shown Table- 4and figure- 4

S. No

Name of The Department

Drops

Syrup

Injections

Tablets

Capsules

Powders

Creams

1

Orthopetic

Nill

70

240

330

250

45

50

2

Gynecology

Nill

150

150

350

210

50

Nill

3

Pediatric

50

120

75

60

8

5

15

4

Total

50

340

465

740

468

100

65

 

 

Figure -4: Based on dosage forms

 

Table -5: Total number of prescriptions 435 based on category of drugs is 2228 are shown in table -5 and figure -5

S. No

Category of Drug

Pediatric

Orthopeatic

Gynocology

Total

1

Anti-Histamin

140

0

32

170

2

Anti-Biotic

200

180

55

435

3

Antipyretic

80

70

43

193

4

Multivitamins

115

80

70

265

5

Bronchodialator

95

0

0

95

6

Aplha Agonist

50

0

0

50

7

Antiemetic

10

0

34

44

8

Antiseptic

15

35

0

50

9

Antifungal

10

0

0

10

10

Antiacid

5

80

42

127

11

Anti Helmintics

7

0

0

7

12

Anti Epileptic

2

45

0

47

13

Nsaids

2

0

0

2

14

Calcium

0

0

80

80

15

Iron Supplements

10

25

47

82

16

Hormon

0

0

80

80

17

Laxatives

0

0

20

20

18

Anti Hypertensive

0

40

0

40

19

Anticoagulant

0

40

10

50

20

Urinary Alkanizes

0

0

18

18

21

Anti Diabetis

0

40

20

60

22

Corticosteroida

0

0

30

30

23

Expectorant

0

12

12

24

24

H2 Blockers

0

0

14

14

25

Antithyroid

0

0

10

10

26

Vaccins

0

0

16

16

27

Anticholinergic

0

35

0

35

28

Antioxidant

0

33

0

33

29

Diuretic

0

15

15

30

30

Angiotension

0

35

0

35

31

Anti Depresants

0

30

0

30

32

Antiarrhythmics

0

40

0

40

 

 

Figure -5: Based on category of drugs

 


 

Table-6: Total number Antibiotics used in three departments 435 shown in Table -6 figure -6

S. No

Name of The Antibiotics

Number

1

Ceftrioxone+Sulbacctum

35

2

Piperacillin+Tazobactam

40

3

Aminoglycoside Antibiotic

25

4

Linezolid

15

5

Ampicillin + Sulbacctum

30

6

Cefuroxime

43

7

Ceftrioxone

35

8

Amoxicillin

25

9

Azithromycin

15

10

Amoxicillin+ Clavulanate

30

11

Prednisolone Sodium Phosphate

15

12

Motelukast Sodium

25

13

Amikacin Sulate

25

14

Cefixime

39

15

Ciprofloxacin

12

16

Ofloxacin

6

17

Gentamicin

10

18

Metronidazole

10

 



Figure -6: Total number of antibiotics

 


 

A total of 435 prescriptions were collected randomly and analyzed. A total of 2228 drugs were prescribed, Average number of drugs per encounter were 5.1. Drugs prescribed from essential drugs list (WHO) were 740(33.21%). Total number of antibiotics prescribed were 435(19.5%) mostly CEFTRIAXONE were prescribed 70(16%)

 

Table-7: analysis of prescriptions in the light of W.H.O prescribing indicators

Parameters

Observed Value

Total number of prescriptions analyzed

435

Total number of drugs prescribed

2228

Total number of drugs prescribed from essential drug list

740

Average number of drugs per encounter

5.1

Total number of antibiotics prescribed

435

Percentage of encounters with an antibiotic prescribed

82.42%

Percentage of encounters with injections prescribed

20.8%

Percentage of drugs prescribed from essential drug list

33.21%

 

CONCLUSION:

Study provides the information about the prospective study of antibiotics utilization in multi-specialty hospital. It has helped to identify irrational prescribing patterns of drugs in various departments like pediatrics, gynaecology orthopedic. Hence, the clinical pharmacist must be considered to be an integral part. They should be involved in collection and presentation of prescribing data as a part of clinical audit and also counseling of patients/ care takers. Pharmaceutical care is needed in the correct management of drugs which is even more important in various departments. The WHO core indicators helped to improvise the prescribing pattern, identify significant problems involved in the knowledge gap of patients or caretakers understanding of instructions provided by consultants and even to minimize the cost burden on patient.

 

ACKNOWLEDGMENT:

Authors acknowledge sincere thanks to the management and Staff of Vinayaka Missions college of Pharmacy, VMU, Salem for the facilities granted, support for the successful completion of research work.

 

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Received on 11.04.2020            Modified on 16.06.2020

Accepted on 21.07.2020         © RJPT All right reserved

Research J. Pharm. and Tech. 2021; 14(4):1957-1960.

DOI: 10.52711/0974-360X.2021.00346