A study on the usage of antimicrobial agents and adverse drug reaction of antimicrobial used in a tertiary care hospital in North East India

Authors

  • Susmita Patowary PhD Scholar, Srimanta Sankaradeva University of Health Sciences, Gauhati Medical College & Hospital, Guwahati, Assam, India
  • Mangala Lahkar Department of Pharmacology, Gauhati Medical College and Hospital, Assam, India
  • Ratan J. Lihite Deptment of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20181488

Keywords:

Antimicrobial agents, Adverse drug reactions, Generic name, Prescription audit

Abstract

Background: Irrational use of antimicrobial agents (AMAs) has led to large scale development of drug resistance and adverse drug reactions (ADRs) which has become a growing world -wide concern. The study was conducted to analyze the prescribing pattern of AMAs and to evaluate the reported ADR of the AMAs prescribed.

Methods: A prospective study was conducted by analyzing 900 case sheets receiving AMAs in a tertiary care hospital. The study plan included analysis of average number of AMA prescribed, morbidity profile of patients, types of AMAs used, drug prescribed by generic/brand name, injectable AMA preparations and appropriateness of indication of AMA used. Thirty reported cases of ADR were evaluated for their casualty by Narnajo’s scale and severity by Hartwigs scale.

Results: Average number of drugs per prescription was 1.54. Most common morbidity was fever due to various causes. 86.2% of AMA used was antibiotics. About 72.0% of AMAs were prescribed by generic name. Percentage of injectable preparation was 85.0%. 65.0% of drugs were prescribed from Essential drug list (EDL). Most offending drug for ADR was fixed drug combination (FDC) 30.0%. Common organ system involved was skin (63.3%). Most of the ADR were possible (80.0%) and mild (76.6%) in nature.

Conclusions: Average number of AMAs per prescription was1.54. Percentage of drug prescribed by generic name is encouraging. However use of injectable preparation was very high. Majority of AMAs prescribed were antibiotics which is also very high. Periodic prescription audit will provide feedback to the prescribers and help in reducing the prescribing error and ADR cases.

References

Kotwani A, Holloway K. Trends in antibiotic use among outpatients in New Delhi, India. BMC Infect Dis. 2011;11:99.

Hughes JM. Preserving the Lifesaving Power of Antimicrobial Agents. JAMA. 2011;305(10):1027-8.

Geetha P, Vijayalakshmi P, Tilak S, Maheswaran A, Narayanan N. Prescription analysis to evaluate the rational use of drugs by using who health care indicators. International journal of Multidisciplinary Research and Development. May 2015;2(5):358-60.

Kshirsagar MJ, Langade D, Patil S, Patki PS. Prescribing pattern among Medical practitoners in Pune, India. Bulletin of World Health Organisation. 1998;76(3):271-5.

Badar VA, Navale SKB. Study of Prescribing Pattern of Antimicrobial agents in Medicine Intensive Care Unit of a Teaching hospital in Central India. JAPI. April 2012;60:20-3.

Pirmohamed M, Breckenridge AM, Kitteringham NR, Park BK. Fortnightly review: adverse drug reactions. BMJ: British Medical Journal. 1998 Apr 25;316(7140):1295-8.

Einarson TR. Drug related hospital admission. Ann pharmacother.1993;27 (7-8):832-40.

Lazarou J, Pomeranz BH and Corey PN. Incidence of Adverse Drug Reaction in Hospitalized Patients. A Meta analysis of Prospective Studies. Journal of American Medical Association. 1998;279(15):1200-5.

Selvaraj R. Prospective assessment of antimicrobial prescribing pattern at a tertiary care hospital. Al Ammen J. Med Sci. 2015;8(4):276-80.

Admane PD, Hiware SK, Mahatme MS, Dudhgoankar SD, Deshmukh SN, Mahajan MM. Prescription pattern of antimicrobials in a tertiary care hospital in central India. Int J Pharmaco Res. 2015;5(2):31-4.

Khan FA, Singh VK, Sharma S, Singh P. A Prospective Study on the Antimicrobial Usage in the Medicine Department of a Tertiary care teaching Hospital. Clin Diagn Res. 2013;7(7):1343-46.

Ahmad A, Revanker M, Haque I, Pravina A, Ivan R, Dasari R, et al. Study the prescription pattern of antibiotics in the medicine department in a teaching hospital: a descriptive study. Int J Toxicol Pharmacol Res. 2014;6(2):43-6.

Harugeri A, Joseph J, Parthasarathi G, Ramesh M, Guido S. Prescribing patterns and predictors of high-level polypharmacy in the elderly population: A prospective surveillance study from two teaching hospitals in India. Am J Geriatr Pharmacother. 2010;8(3):271-80.

Karim A, Atif MA, Irshad M, Khalid F. Survey of antibiotic utilization at Sheikh Zayed Hospital. J Shiekh Zayed Med College Rahim Yar Khan. 2011;2(2):168-70.

Pandiamunian J, Somasundaram G. A study on prescribing pattern of anti microbial agents in the medical intensive care unit of a tertiary care hospital in Puducherry Union Territory, South India. Int J Pharm Sci. 2014;6(3):235-8.

Jimoh AO, Etuk EU, Sani Z, Shuaibu HA. The pattern of antibiotic use in a family medicine department of a tertiary hospital in Sokoto, North Western Nigeria. Journal of clinical and diagnostic research. 2011;5(3):566-9.

McGowan JE Jr. Economic impact of antimicrobial resistance. Emerg Infect Dis. 2001;7(2):286-92.

Shrivastava M, Uchit G, Chakravarti A, Joshi G, Mahatme M, Chaudhari H. Adverse drug reactions reported in Indira Gandhi government medical college and hospital, Nagpur. J Assoc Physicians India. 2011 May;59:296-9.

Dhar K, Sinha A, Gaur P, Goel R, Chopra VS, Bajaj U. Pattern of adverse drug reactions to antibiotics commonly prescribed in department of medicine and pediatrics in a tertiary care teaching hospital, Ghaziabad. J App Pharm Sci. 2015;5(4):78-82.

Shamna M, Dilip C, Ajmal M, Mohan PL, Shinu C, Jafer CP, et al. A prospective study on Adverse Drug Reactions of antibiotics in a tertiary care hospital. Saudi pharmaceutical journal. 2014 Sep 1;22(4):303-8.

Halkai K, Deshmukh SK, Rao YV. An Evaluation of Adverse Drug Reactions at ADR Monitoring Centre in Tertiary Care Hospital. International Journal of Therapeutic Applications. 2016;32:86-9.

Steinman MA, Rosenthal GE, Landefeld CS, Bertenthal, Daniel MPH, Sen Saunak. Conflicts and concordance between measures of medication and prescribing quality. Med Care. 2007;45(1):95-9.

Singh H, Dulhani N, Kumar B, Singh P, Tewari P, Nayak K. A pharmacovigilance study in medicine department of tertiary care hospital in Chhattisgarh (Jagdalpur), India. J Young Pharm. 2010;2(1):95-100.

Jose J, Rao PGM, Jimmy, Beena. Adverse drug reactions to fluoroquinolone antibiotics - Analysis of reports received in a tertiary care hospital. Int J Risk Saf Med. 2008;20:169-80.

Stavreva, G, Pendicheva, D, Pandurska A, Marev R. Detection of adverse drug reactions to antimicrobial drugs in hospitalized patient. Trakia J Sci. 2008;6(1):7-9.

Priyadharsini R, Surendiran A, Adithan C, Sreenivasan S, Sahoo, Kumar F. A study on adverse drug reactions in pediatric patients. J Pharmacol Pharmacother. 2011;2(4):272-80.

Downloads

Published

2018-04-23

How to Cite

Patowary, S., Lahkar, M., & Lihite, R. J. (2018). A study on the usage of antimicrobial agents and adverse drug reaction of antimicrobial used in a tertiary care hospital in North East India. International Journal of Basic & Clinical Pharmacology, 7(5), 833–838. https://doi.org/10.18203/2319-2003.ijbcp20181488

Issue

Section

Original Research Articles