Antimicrobial Prescribing Practices at Dermatology Outpatient Departments in Tertiary Care Hospitals: A multi-centered, Cross Sectional Study

Abstract

Background: The purpose of this study is to evaluate antimicrobial prescribing behaviors in the dermatology outpatient department. Methods: This multi-centered, cross-sectional study was conducted at dermatology outpatient department of three tertiary care hospitals in Chittagong division, Bangladesh during the period October, 2021 to April, 2022. Results: During the study period, 463 prescriptions were obtained. Over half of the participants were female (57%) and between the ages of 21 to 40 years. The majority of patients were diagnosed with eczema (19%), acne (17%), and scabies (15%). Most commonly prescribed antimicrobials was Azithromycin (22%), followed by Permethrin (16%) and Erythromycin (7%). In most cases, antimicrobials were recommended for more than two weeks (60%). Nearly half of the antimicrobials (53 %) were recommended as combination of systemic and topical route. Conclusion: Current study found that dermatologists frequently recommended broad-spectrum antimicrobials for extended periods of time, which may lead to antimicrobial resistance. There is a need for continuing medical education on the appropriate use of antimicrobials, which will result in the effective management of skin diseases.

A study on drug usage pattern of antibiotics in patients with skin disorders

“…These findings are similar to the study by Divyashanthi et al, 30 The study by Chakrawarty et al, 31 demonstrates two interesting facts; first, their most preferred route was oral which is similar to our study, but the least preferred route was parenteral which is in contrast to our study. Our study findings deviate from the studies by Gupta et al, 34 Bahela et al, 33 and Sultana et al, 32 in which the combination of oral and topical were the most preferred choices.…”

“…Our findings show that, the most people affected are in the age group 21-40 (36%), which is similar to the studies of Sultana et al, 32 and Chakrawarty et al, 31 with percentages 58% and 47% respectively. These findings are different from the study of Divyashanthi et al, 30 where 41-60 age group was predominantly affected.…”

“…Our findings showed that males were predominantly affected by bacterial skin diseases than the female with percentages 64% and 36% respectively. This result is similar to studies by Divyashanthi et al, 30 (60.48% males and 39.5% females), Chakrawarty 32 that demonstrated a percentage of 57 for females and 43 for males. It is not similar to the study of Bahelah et al, 33 in which females had a percentage of 57.2.…”

“…The category wise distribution in the present study shows that penicillins (32%) and cephalosporins (32%) contributed to a higher percentage which is in contrast to the studies of Bahelah et al, 33 Sultana et al, 32 where macrolides contributed a larger volume (39.5% and 33.2% respectively) and study by Chakrawarty et al, 31 where tetracyclines was commonly prescribed 33.8%.…”

“…The most frequently prescribed oral antibiotics were Cephalexin and Amoxicillin (27% and 20% respectively) which is almost similar to the study of Chakrawarty et al, 31 their study showed that the most commonly prescribed drugs were Doxycycline (33.87%) and Amoxicillin (24.34%).Our study results are in contrast to the studies of Divyashanthi et al, 30 Gupta et al, 34 Sultana et al, 32 where amoxicillin clavulanic acid (29.6%), Doxycycline(16.3%), Azithromycin(22%) are commonly prescribed drugs.…”