DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160119

Study of patterns of prescribing antibiotics in geriatric patients admitted to the medical wards in a tertiary care hospital

Ankita Bist, Gajanan P. Kulkarni, Kashinath M. Gumma

Abstract


Background: Evidence indicates high prevalence of inappropriate prescribing of medicines especially in the elderly. This can cause increased incidence of adverse drug reactions, morbidity, mortality and cost of treatment. Also inappropriate use of antibiotics promotes emergence of antimicrobial resistance. This study aims to study the prescribing patterns of antibiotics administered in geriatric patients, disease conditions for which the antibiotics were prescribed and adherence of these antibiotic prescriptions to the 18th WHO essential medicine list.

Methods: A prospective study was undertaken, over duration of 4 months at the government teaching hospital, Bidar Institute of Medical sciences, Bidar. Patients of either sex above 65 years of age admitted to medicine wards due to infections or those who acquired infection due to hospitalization and were on antibiotic treatment / prophylaxis were included. Data collection was done by scrutinizing the inpatient case sheets and investigation reports. Individual data was collected on preformed performa.

Results: Out of the 140 patients 44.2% patients were admitted for treatment of respiratory tract infections. 17.1% of the patients received antibiotics prophylactically. Cefotaxime was observed to be the most commonly prescribed antimicrobial agent. It was included in 50% of antibiotic prescriptions. It was observed that 90% of antibiotics prescribed were in adherence to the WHO essential drug list.

Conclusions: Polypharmacy is commonly observed practice in geriatric patients. Apart from increasing the cost of treatment it also promotes irrational prescription of drugs. Most of the prescriptions were in adherence with the WHO’s Essential Medicine List but antibiotics were mainly prescribed empirically.


Keywords


Geriatric, Antibiotics, Prescribing patterns

Full Text:

PDF

References


Mclean AJ, Le couteur DG. Aging biology and geriatric clinical pharmacology. Pharmacol Rev. 2004;56(2):163-84.

Shah RR. Drug development and use in the elderly: search for the right dose and dosing regimen. British J Clin Pharmacol. 2004;58(5):452-69.

Nathiya D, Pandey K, Sharma RK. A study on drug utilization pattern of antimicrobials in outpatient department of medicine at tertiary care hospital. Int J Res Pharm Sci. 2014;4(2):40-5.

Preeth M, Shobana J. Study on prescribing patterns of antibiotics used in the management of various infectious diseases in Andhrapradesh. Int Res J Pharm. 2011;2(7):112-5.

Bansal D, Mangla S, Undela K, Gudala K, D’Cruz S, Sachdev A et al. Measurement of adult antimicrobial drug use in tertiary care hospital using defined daily dose and days of therapy. Indian J Pharm Sci. 2014;76(3):211-7.

Henry F C. General principles of antimicrobial therapy. In: Laurence L. ed. Goodman and Gillman’s The pharmacological basis of therapeutics. 11th ed. USA: McGraw-Hill;2006:1095-09.

Badar VA, Kumar S, Navale B. Study of prescribing pattern of antimicrobial agents in medicine intensive care unit of a teaching hospital in central India. JAPI. 2012;60:20-3.

Remesh A, Salim S, Gayathri AM, Nair U, Retnavally KG. Antibiotics prescribing pattern in the in‑patient departments of a tertiary care hospital. Arch Pharm Pract. 2013;4(2):71-6.

Williams A, Mathai AS, Phillips AS. Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. J Pharm Bioal Sci. 201;3(4):531-6.

Ozgenç O, Genç VE, Arı AA, Sibel E, Saçar S, Ozunlu H et al. Evaluation of the therapeutic use of antibiotics in Aegean region hospitals of Turkey: a multicentric study. Indian J Med Microbiol. 2011;29(2):124-9.

WHO model lists of essential medicines 18th ed. Geneva: World Health Organization, 2013. Available at: http://www.who.int/ medicines/publications/ essentialmedicines/en/ index.html. Accessed 19 Jan 2015.

Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi CB. Drug utilization pattern and pharmacoeconomic analysis in geriatric medical in­ patients of a tertiary care hospital of India. J Pharmacol Pharmacother. 2014;5(1):15-20.