A prospective study to evaluate antimicrobial prescribing pattern among admitted patients in hilly Himalayan region of northern India.
ADR profiling
W.H.O indicators
antimicrobial/antibiotic
consumption
Journal
Journal of family medicine and primary care
ISSN: 2249-4863
Titre abrégé: J Family Med Prim Care
Pays: India
ID NLM: 101610082
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
21
06
2020
revised:
08
09
2020
accepted:
22
09
2020
entrez:
14
6
2021
pubmed:
15
6
2021
medline:
15
6
2021
Statut:
ppublish
Résumé
Global scenario of antimicrobial (AM) utilization depicts 20-50% inappropriateness. Majority of the hospital admissions are due to unwanted effects because of non-judicial usage of these drugs. The present study focuses on utilization pattern of antimicrobials (AMs) in a tertiary care hospital in northern India. A prospective observational study was conducted over a period of one year in seven departments of a tertiary care hospital in hilly Himalayan region. Aim of the study was to analyze the AM utilization pattern using World Health Organization (WHO) indicators and instruments. A total 700 prescriptions were analyzed in the present study. Injectable antibiotics (71%) followed by oral (29%) were most commonly prescribed. Beta lactams (79%) were the most frequently used antibiotic class. Most commonly prescribed AM was Ceftriaxone (30%). Majority of the time AMs were given empirically (44.8%), where most common indication was respiratory infections (42%). Culture and sensitivity tests were done for guiding curative therapy in 34.71% cases. The average duration of patient hospital stay was 8.81 days in the study population. The mean duration of prescribed antimicrobial treatment was 5.12 days. On an average 1.93 AMs were prescribed per patient. AMs were prescribed by International nonproprietary name (INN) in 62.19% of the admissions. The most common AM related adverse drug reaction was gastritis (96%) and skin rash (4%) with Amoxicillin + clavulanic acid being the most common causative agent. Total antimicrobial consumption was 148.24 DDD/100 bed days with Medicine department showing the highest consumption (36.25/100 bed days). The present study is the first and largest antimicrobial utilization study in the hilly Himalayan region of northern India. Our study found an urgent need for improvement of prescribing patterns, patient care indicators and strict adherence to standard guidelines.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Global scenario of antimicrobial (AM) utilization depicts 20-50% inappropriateness. Majority of the hospital admissions are due to unwanted effects because of non-judicial usage of these drugs. The present study focuses on utilization pattern of antimicrobials (AMs) in a tertiary care hospital in northern India.
MATERIALS AND METHODS
METHODS
A prospective observational study was conducted over a period of one year in seven departments of a tertiary care hospital in hilly Himalayan region. Aim of the study was to analyze the AM utilization pattern using World Health Organization (WHO) indicators and instruments.
RESULTS
RESULTS
A total 700 prescriptions were analyzed in the present study. Injectable antibiotics (71%) followed by oral (29%) were most commonly prescribed. Beta lactams (79%) were the most frequently used antibiotic class. Most commonly prescribed AM was Ceftriaxone (30%). Majority of the time AMs were given empirically (44.8%), where most common indication was respiratory infections (42%). Culture and sensitivity tests were done for guiding curative therapy in 34.71% cases. The average duration of patient hospital stay was 8.81 days in the study population. The mean duration of prescribed antimicrobial treatment was 5.12 days. On an average 1.93 AMs were prescribed per patient. AMs were prescribed by International nonproprietary name (INN) in 62.19% of the admissions. The most common AM related adverse drug reaction was gastritis (96%) and skin rash (4%) with Amoxicillin + clavulanic acid being the most common causative agent. Total antimicrobial consumption was 148.24 DDD/100 bed days with Medicine department showing the highest consumption (36.25/100 bed days).
CONCLUSION
CONCLUSIONS
The present study is the first and largest antimicrobial utilization study in the hilly Himalayan region of northern India. Our study found an urgent need for improvement of prescribing patterns, patient care indicators and strict adherence to standard guidelines.
Identifiants
pubmed: 34123900
doi: 10.4103/jfmpc.jfmpc_1230_20
pii: JFMPC-10-1607
pmc: PMC8144753
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1607-1613Informations de copyright
Copyright: © 2021 Journal of Family Medicine and Primary Care.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Exp Ther Med. 2016 Aug;12(2):961-964
pubmed: 27446303
Pharmacotherapy. 2007 Sep;27(9):1306-12
pubmed: 17723084
Ann Intern Med. 1973 Oct;79(4):555-60
pubmed: 4795880
Saudi Pharm J. 2014 Sep;22(4):303-8
pubmed: 25161373
Ann Clin Microbiol Antimicrob. 2020 Feb 17;19(1):7
pubmed: 32066448
Indian J Crit Care Med. 2018 Jun;22(6):422-426
pubmed: 29962742
Medicine (Baltimore). 2016 Nov;95(47):e5064
pubmed: 27893655
PLoS One. 2018 Apr 13;13(4):e0195901
pubmed: 29652932
BMC Res Notes. 2018 Dec 18;11(1):904
pubmed: 30563558
Kathmandu Univ Med J (KUMJ). 2005 Apr-Jun;3(2):130-7
pubmed: 16415608
BMC Infect Dis. 2014 Jan 09;14:13
pubmed: 24405683
Ther Adv Infect Dis. 2018 Jul;5(4):63-68
pubmed: 30013773
Int J Crit Illn Inj Sci. 2013 Oct;3(4):250-5
pubmed: 24459622
Antimicrob Resist Infect Control. 2017 Apr 28;6:41
pubmed: 28465825
Eur J Clin Pharmacol. 2000 Apr;56(1):97-101
pubmed: 10853885
Infection. 2008 Dec;36(6):560-4
pubmed: 19011742
Biomed Res Int. 2017;2017:4304973
pubmed: 29457026
Eur J Clin Pharmacol. 2017 Jun;73(6):759-770
pubmed: 28251277
J Clin Diagn Res. 2016 Aug;10(8):FC01-4
pubmed: 27656459
Yonsei Med J. 2012 Sep;53(5):1022-7
pubmed: 22869488
Kathmandu Univ Med J (KUMJ). 2004 Jan-Mar;2(1):6-12
pubmed: 19780281
BMC Infect Dis. 2012 Jul 12;12:155
pubmed: 22788873
J Epidemiol Glob Health. 2015 Jun;5(2):143-50
pubmed: 25922323
Indian J Pharmacol. 2013 May-Jun;45(3):252-7
pubmed: 23833368
Antibiotics (Basel). 2017 Sep 13;6(3):
pubmed: 28902135
J Clin Diagn Res. 2013 Jul;7(7):1343-6
pubmed: 23998062
Indian J Crit Care Med. 2018 Oct;22(10):723-729
pubmed: 30405283
Am J Trop Med Hyg. 2020 Feb;102(2):370-376
pubmed: 31802729
Br J Clin Pharmacol. 1995 Jan;39(1):1-6
pubmed: 7756093
Clin Microbiol Rev. 2005 Oct;18(4):638-56
pubmed: 16223951
Aust Prescr. 2019 Feb;42(1):5-9
pubmed: 30765902
Clin Microbiol Infect. 2009 Apr;15 Suppl 3:12-5
pubmed: 19366364
Antimicrob Resist Infect Control. 2018 Apr 25;7:58
pubmed: 29713465
J Antimicrob Chemother. 2005 May;55(5):805-8
pubmed: 15814603
PLoS One. 2020 Jan 30;15(1):e0227736
pubmed: 31999752
BMC Health Serv Res. 2018 May 3;18(1):326
pubmed: 29724214
J Nepal Health Res Counc. 2018 Oct 30;16(3):279-284
pubmed: 30455486