Prescribing indicators and pattern of use of antibiotics among medical outpatients in a teaching hospital of Central Nepal

Abstract

The study of prescriptions using prescribing indicators enables us to detect some common problems of prescribing and to focus subsequent efforts to correct them. This study was designed to define the extent and pattern of drug prescribing with emphasis on that of antibiotics among medical outpatients of teaching hospital of College of Medical Sciences Bharatpur, Nepal. The data contained on randomly selected original prescriptions of patients attending medical OPD in between January2008 and June2008 were collected prospectively on duplex prescriptions and analyzed. A total of 955 drugs were prescribed to 339 patients. The average number of drugs per encounter was 2.81. Drugs prescribed by generic name were 20.31% and those matched to national essential drugs list were 49.63%. Encounters with antibiotics were 43.95%. Antibiotics were the most frequently prescribed therapeutic class. Azithromycin, ciprofloxacin and amoxycillin were three most frequently prescribed antibiotics. Respiratory tract infection was the most common indication, for which antibiotics were given. Selections of antibiotics were rational for most of the indications but bacteriological confirmation prior to institution of antibiotics were not done in any case. Polypharmacy, inclination for branded products and overuse of antibiotics were revealed as problems requiring educational interventions and strict antibiotic policy as subsequent efforts to rectify them. Key words: Antibiotics; medical outpatients; prescribing indicators; teaching hospital. DOI: 10.3126/jcmsn.v6i2.3610 Journal of college of Medical Sciences-Nepal, 2010, Vol.6, No-2, 7-13

Prescription pattern of antimicrobial drugs in pediatrics outpatient department of a tertiary care teaching hospital of North India

“…12 The mean of antibiotics prescribed from NLEM of India showed that not all the antimicrobials included from the NLEM of India. A mono drug prescription in the retrospective study was found to be consistent with the study conducted in Nepal 15 and the WHO guidelines. [17][18][19][20] The frequently of single antibiotic prescription was consistent with other studies and the WHO guidelines.…”

“…This result was consistent with the study conducted in Italy. 15 The majority of common childhood illnesses are caused by viruses which do not require antibiotics. The proportion of antibiotic prescription was 79.4% in the present study as against the WHO recommendation of 20% antibiotic use for these common childhood illnesses.…”

The Knowledge, Attitude and the Perception of Prescribers on the Rational Use of Antibiotics and the Need for an Antibiotic Policy–A Cross Sectional Survey in a Tertiary Care Hospital

“…Although the prescribing was rational, it was felt that an inclination towards branded products and an over use of antibiotics were prevalent. The need of an educational intervention, as well as a strict antibiotic policy was felt [10]. Developing and maintaining an electronic documentation of the patients' medical records may serve as a valuable tool for auditing the prescriptions frequently and for implementing the antibiotic policy.…”

“…Although the selections of the antibiotics were rational, bacteriological confirmations prior to the institution of antibiotics, were not done in any case. The inclination towards the use of branded products and the overuse of antibiotics were revealed as the problems which required educational interventions and a strict antibiotic policy [10].…”

“…The concept of rational drug use is new in the developing countries [9] and it refers to prescription of the right drug to the right patient, in the right dose, at right time intervals and for the right duration [10]. Some measures are required for the rational drug in [Table/ Fig-1].…”