Drug usage pattern of antimicrobials in elderly hypertensive, diabetic in-patients with or without impaired renal function

Authors

  • Prasan R. Bhandari Department of Pharmacology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India
  • Apeksha Bhandary Department of Pharmacology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20183928

Keywords:

Antimicrobial, Drug utilization, Renal impairment

Abstract

Background: Hypertension (HTN) and diabetes mellitus (DM) are the primary contributors to renovascular mortality and morbidity including chronic kidney diseases. Additionally, these patients are in frequent need of an antimicrobial agent. Drug utilisation studies (DUS) are prospective tools in the assessment of health care systems. The objective of the present study was to analyse the prescription pattern of anti-microbials in elderly hypertensive diabetic in-patients with or without renal impairment in a tertiary hospital

Methods: The study population comprised of 165 hypertensive diabetic in-patients at Shri Dharmasthala Manjunatheshwara (SDM) Hospital. Questionnaire based evaluation was carried out and prescriptions of patient with HTN and DM at and above the age of 60 years irrespective of gender were included.

Results: Among anti-microbial agents, other β lactam antibacterial were the most commonly prescribed class of drugs (40.85%) which was similar in patients with impaired renal function (21.8%).

Conclusions: There was a significant increase in the number of anti-microbial agents and other drugs in the patients with impaired renal function when compared to patients with normal renal function (p <0.05).

Metrics

Metrics Loading ...

References

Levey AS, Coresh J. Chronic kidney disease. The lancet. 2012 Jan 14;379(9811):165-80.

Levey AS, Coresh J, Bolton K, Culleton B, Harvey KS, Ikizler TA, et al. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 SUPPL. 1).

Manley HJ, Drayer DK, Muther RS. Medication-related problem type and appearance rate in ambulatory hemodialysis patients. BMC Nephrol. 2003 Dec;4(1):10.

Kappel J, Calissi P. Nephrology: 3. Safe drug prescribing for patients with renal insufficiency. Canad Med Assoc J. 2002 Feb 19;166(4):473-7.

World Health Organization: Burden of Disease Project. Available at http://www3.who.int/whosis/menu.cfm (accessed on 2014 Nov).

Roberts JA, Lipman J. Pharmacokinetic issues for antibiotics in the critically ill patient. Cri Care Med. 2009 Mar 1;37(3):840-51.

Wanigasuriya KP, Peiris-John RJ, Wickremasinghe R, Hittarage A. Chronic renal failure in North Central Province of Sri Lanka: an environmentally induced disease. Transactions Royal Soc Trop Med Hygiene. 2007 Oct 1;101(10):1013-7.

Le Grand A, Hogerzeil HV, Haaijer-Ruskamp FM. Intervention research in rational use of drugs: a review. Health Policy Planning. 1999 Jan 1;14(2):89-102.

Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Ann Intern Med. 2003;139:137-47.

Long CL, Raebel MA, Price DW, Magid DJ. Compliance with dosing guidelines in patients with chronic kidney disease. Ann Pharmacother. 2004 May;38(5):853-8.

Manley HJ, Cannella CA, Bailie GR, Peter WL. Medication-related problems in ambulatory hemodialysis patients: a pooled analysis. Am J Kidney Dis. 2005 Oct 1;46(4):669-80.

WHO Collaborating Centre for Drug Statistics Methodology (2009) Guidelines for ATC classification and DDD assignment. 2010. Accessed on 2013 Jan 05. Available at http://www.whocc.no/filearchive/publications/2010guidelines.pdf.

Koristkova B, Grundmann M, Brozmanova H. Differences between prescribed daily doses and defined daily doses of antiepileptics--therapeutic drug monitoring as a marker of the quality of the treatment. Int J Clin Pharmacol Therapeut. 2006 Sep 1;44(9).

Muller A, Monnet DL, Talon D, Hénon T, Bertrand X. Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospital. Br J Clin Pharmacol. 2006 May;61(5):585-91.

Duarte‐Ramos F, Cabrita J. Using a pharmacoepidemiological approach to estimate diabetes type 2 prevalence in Portugal. Pharmacoepidemiol Drug Safety. 2006 Apr;15(4):269-74.

Grimmsmann T, Himmel W. Discrepancies between prescribed and defined daily doses: a matter of patients or drug classes?. Eur J Clin Pharmacol. 2011 Aug 1;67(8):847-54.

Ramachandran G, Rohith V, Topno I. Evaluation of prescribing pattern of anti-diabetic drugs using WHO prescribing indicators in a tertiary care hospital in Puducherry: a cross-sectional study. Pharma Innovation. 2015 Jul 1;4(5, Part B):76.

Santra S, Agrawal D, Kumar S, Mishra SS. A study on the drug utilization pattern in patients with chronic kidney disease with emphasis on antibiotics. J Integrative Nephrol Androl. 2015 Jul 1;2(3):85.

Abraham F, Varughese G, Mathew JC, John PM, Sam GK. Drug utilization pattern among geriatric patients in a tertiary care teaching hospital. Asian J Pharm Clin Res. 2015;8(6):191-4.

Bajait CS, Pimpalkhute SA, Sontakke SD, Jaiswal KM, Dawri AV. Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders. Indian J Pharmacol. 2014 Jan;46(1):35.

Pavitra RY, Geeta M, Aggarwal R, Somashekhar HS. Drug utilization pattern of antihypertensive drugs in chronic kidney disease patients in a tertiary care hospital. J Dental Med Sci. 2014;13(11):23-7.

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 Pharmacotherapeut. 2014 Jan;5(1):15.

Al-Ramahi R. Medication prescribing patterns among chronic kidney disease patients in a hospital in Malaysia. Saudi J Kidney Dis Transplantation. 2012 Mar 1;23(2):403.

Bajait CS, Pimpalkhute SA, Sontakke SD, Jaiswal KM, Dawri AV. Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders. Indian J Pharmacol. 2014 Jan;46(1):35.

Bushardt RL, Massey EB, Simpson TW, Ariail JC, Simpson KN. Polypharmacy: misleading, but manageable. Clin Interventions Aging. 2008 Jun;3(2):383.

Swan SK, Bennett WM. Drug dosing guidelines in patients with renal failure. Western J Med. 1992 Jun;156(6):633.

U.S Renal Data System (USRDS) Annual Data Report: atlas of end-stage renal disease in the United States. Bethesda: national institutes of health, national institute of diabetes and digestive and kidney diseases; 2006.

Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007 Nov 7;298(17):2038-47.

van Dijk EA, Drabbe NR, Kruijtbosch M, De Smet PA. Drug dosage adjustments according to renal function at hospital discharge. Ann Pharmacother. 2006 Jul;40(7-8):1254-60.

Falconnier AD, Haefeli WE, Schoenenberger RA, Surber C, Martin‐Facklam M. Drug dosage in patients with renal failure optimized by immediate concurrent feedback. J General Internal Med. 2001 Jun;16(6):369-75.

Liano F, Pascual J, Madrid Acute Renal Failure Study Group. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Kidney Int. 1996 Sep 1;50(3):811-8.

Downloads

Published

2018-09-24

How to Cite

Bhandari, P. R., & Bhandary, A. (2018). Drug usage pattern of antimicrobials in elderly hypertensive, diabetic in-patients with or without impaired renal function. International Journal of Basic & Clinical Pharmacology, 7(10), 1946–1953. https://doi.org/10.18203/2319-2003.ijbcp20183928

Issue

Section

Original Research Articles