Cephalosporin utilization in the inpatient wards of a teaching hospital in Western Nepal

Barvaliya

Int J Crit Illn Inj Sci

et al. 2013

Aims:The aim of this study is to evaluate the drug utilization pattern and pharmacoeconomic analysis in critical care unit (CCU).Materials and Methods:Indoor case papers of patients admitted in CCU between January 2008 and December 2010 were analyzed for demographic variables; indications; duration of CCU stay; proportion of common drugs used. Use of antimicrobials was evaluated based on the culture report and empirical regimen used. Defined daily dose (DDD)/100 bed-days were calculated. Various World Health Organization prescribing indicators were evaluated. Cost of drugs was calculated from Indian Drug Review (2010).Results:A total of 397 cases were evaluated with a mean age of 44.62 years (95% confidence interval [CI]: 42.56-46.69). Average duration of CCU stay was 4.15 days (95% CI: 3.79-4.51). The average number of drugs prescribed per patient was 13.54 (95% CI: 13.05-14.04). Total drug utilization in terms of DDD/100 bed-days was 226.27. Metronidazole, cefotaxime, atropine, adrenaline, dopamine, dobutamine, deriphyllin, ranitidine, metoclopramide and furosemide were prescribed in more than 30% cases. Number of antimicrobials prescribed per patient was 2.50 (95% CI: 2.37-2.66). Cefotaxime + metronidazole (26.70%) were the most common empirical regimen used. Average cost of treatment per patient was Rs 3225.70 (95% CI: 2749.8-3701.6). Higher economic burden was noted among expired patients and admitted due to medical + surgical indication (P < 0.05).Conclusion:Poly-pharmacy and use of antimicrobials without culture report is a common problem in CCU.

Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India

Barvaliya

Int J Crit Illn Inj Sci

et al. 2013

“…Most of them lack adequate knowledge about disease process and most dispense irrationally. 5 Shankar PR et al, 2005 22 …”

Section: Resultsmentioning

confidence: 99%

Relevance of pharmacoepidemiology to Nepal

Thapa

Palaian²,

Aljadhey³

et al. 2013

AMJ

Drug-related problems such as overuse of injectable drug products and antimicrobials, increased cost of drug therapy, polypharmacy, and adverse drug reactions (ADRs) are prevalent in the healthcare settings of Nepal. To date, no new drug development processes or clinical trials have been conducted in Nepal, despite the fact that studies of real life situations are an essential tool for monitoring medicine use. Pharmacoepidemiology (PE) is an important area that evaluates the effects of drug use in large populations. Data obtained from pharmacoepidemiological studies may highlight ways to reduce certain drug-related problems and provide reliable information on the safety profile of a drug. Moreover, clinicians and regulatory authorities may also use the data to make drug therapy decisions, drug regulation and policy development. Therefore, there is a great need to conduct appropriate pharmacoepidemiological studies that involve multiple regions and in various groups of the population of Nepal, to collect unbiased and reliable information on drug use.

“…This agrees with other studies on elderly where intravenous fluids were prescribed in 34.8% and 61% of elderly inpatients admitted in Western and Eastern Nepal, respectively. [2228]…”

Section: Discussionmentioning

confidence: 99%

Geriatric Prescription in a Nigerian Tertiary Hospital

Osemeke

Hart

Cosmas

et al. 2017

J Basic Clin Pharma

Objectives:To assess the medications prescribed for elderly inpatients on specific days during hospital admission with a view to detecting areas of irrational prescription.Methods:It was a prospective study of all patients aged 65 years and above admitted to the medical wards of a Nigerian tertiary hospital over a 12-month period. The World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators were used to assess drug prescriptions on various days of admission.Results:A total of 1513 patient encounters involving 345 patients aged between 65 and 92 years were assessed on hospital days 1, 3, 5, 7, 14, and 28. The average number of medicines per encounter ranged from 6.1 ± 2.5 on hospital day 1 to 7.8 ± 2.4 on hospital day 28. This difference was statistically significant (F = 14.42; P < 0.05). The percentage of encounters with an antibiotic prescribed ranged from 50.4% on hospital day 1 to 62.9% on hospital day 28 while the percentage of encounters with an injection prescribed decreased from 72.8% on hospital day 1 to 50.0% on day 28.Conclusions:This study suggests some degree of irrational prescribing as evident by the high average number of medicine per encounter and the high percentages of encounters with an antibiotic or injection prescribed. However, there is a need to develop standard values for the WHO/INRUD indicators based on the recently published national treatment guidelines for common elderly diseases which will serve as yardsticks to assess elderly inpatients prescriptions using WHO/INRUD core indicators in future studies.