Evaluation of pattern of prescribing of antimicrobials in Government Doon Hospital and assessment of their rational use

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dc.contributor.authorSingla, Ren_US
dc.contributor.authorBahuguna, Sen_US
dc.contributor.authorBhatt, R.en_US
dc.date.accessioned2023-06-27T06:37:05Z
dc.date.available2023-06-27T06:37:05Z
dc.date.issued2022-04
dc.description.abstractBackground: Rational antimicrobial therapy means that the patients receive medications appropriate to their clinical needs, in needs, in doses that meet their own individual requirements for an adequate period of time and at the lowest cost they and the community can afford. Aim and Objective: The present study was aimed at assessing antibiotic prescribing pattern in eight clinical departments of Government Doon Hospital and to assess their rational use according to the indication, dose, duration, frequency, route of administration, any drug interactions, and contraindications (suitability). Materials and Methods: It was a cross-sectional observational study carried out in the Government Doon Hospital for a period of 3 months. Total 280 prescriptions, at least 20–30 each from eight clinical departments from OPD and IPD (Medicine, surgery, gynecs, orthopedics, ENT, ophthalmology, dermatology, and dentistry), were included in the study. Results: In our study, out of total 1202 drugs prescribed to 280 patients, 493 antibiotics were prescribed. The most commonly prescribed antibiotics were b lactams (39.75) followed by nitro imidazoles (22.9%), azoles (8.11%), and aminoglycosides (7%). The type of the treatment used is empirical in 28.5% cases, prophylactic in 5% cases, and definitive therapy in 66.42 % cases. In fixed dose combinations, total FDCs prescribed were 26. The most commonly used FDCs were amoxiclav and Piptaz. The most frequently prescribed antibiotics were ceftriaxone, amikacin, and metronidazole. The majority of the diseases in which antibiotics were prescribed were alcoholic liver disease, liver abscess, burns, tinea corporis, vaginitis and pain in lower abdomen, and tuberculosis. The number of rational prescriptions in our study is 68.28% according to the indication, dose, duration, frequency, and route of administration in accordance with standard treatment guidelines. The number of irrational prescriptions is 31.72% in terms of inappropriate antibiotic (13.48%), treatment without indication (25.84%), long duration of dosing (40.44%), and inappropriate frequency (17.97%). The prescribing from hospital formulary was 71% while the prescribing from national essential drug list was 65.5% which is still less compared to the WHO guidelines. Conclusion: The irrational prescribing by use of duplicate antibiotics of the same class, using inappropriate antibiotics, using the antibiotic for prolonged periods and incorrect frequency, should be discouraged. The irrational use causes harm to the patient, dissatisfaction, and prolongs hospital stay. The injectables should be given only in case of emergency or systemic infections, reducing the cost, and inconvenience. Rational fixed dose combinations improve compliance, produce synergism and reduce the severity of adverse effects, and prevent emergence of resistance. De-escalation practice, dose optimization, and drug modification/change should be practiced to shorten hospital stay and improve the outcome.en_US
dc.identifier.affiliationsDepartment of Pharmacology, Government Doon Medical College, Dehradun, Uttarakhand, Indiaen_US
dc.identifier.affiliationsMedical Intern, Government Doon Medical College, Dehradun, Uttarakhand, Indiaen_US
dc.identifier.citationSingla R, Bahuguna S, Bhatt R.. Evaluation of pattern of prescribing of antimicrobials in Government Doon Hospital and assessment of their rational use. National Journal of Physiology, Pharmacy and Pharmacology. 2022 Apr; 12(4): 541-545en_US
dc.identifier.issn2231-3206
dc.identifier.issn2320-4672
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/217533
dc.languageenen_US
dc.publisherMrs Dipika Charan of MedScience (India) Publicationsen_US
dc.relation.issuenumber4en_US
dc.relation.volume12en_US
dc.source.urihttps://dx.doi.org/10.5455/njppp.2022.12.03102202207032022en_US
dc.subjectDoseen_US
dc.subjectDurationen_US
dc.subjectFrequencyen_US
dc.subjectDrug Interactionsen_US
dc.subjectResistanceen_US
dc.titleEvaluation of pattern of prescribing of antimicrobials in Government Doon Hospital and assessment of their rational useen_US
dc.typeJournal Articleen_US
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