Prescribing pattern of fixed dose combinations of antibiotics in a post-operative surgical ward of tertiary care teaching hospital

Authors

  • Velvizhy R. Department of Pharmacology, Annaii Medical College & Hospital, Pennalur, Sriperambadur, Kanchipuram 603402, India
  • Johan Pandian J. Department of Pharmacology, Mahatma Gandhi Medical College & Research Institute, Pillaiyarkuppam, Puducherry 607402, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20184841

Keywords:

Drug utilization studies, Fixed dose combinations, Irrational combinations, WHO essential FDC list

Abstract

Background: Fixed dose drug combinations (FDCs), are combinations of two or more active drugs. It should be used when the combination has an established advantage over single drug in efficacy, safety and compliance. The World Health Organization (WHO) lists only 19 of such combinations. But Indian market is filled with hundreds of FDCs which were not approved leading to irrational use. This study was focused on finding out the fixed dose combination of antimicrobial agents used in the post-operative general surgery ward of a tertiary care teaching hospital.

Methods: After getting approval from institutional human ethics committee the prescriptions of patients admitted during April 2013 to March 2014 were analyzed. Demographic data, FDC prescribed by surgeons, Dose, Frequency, Duration, Route, Formulation, Brand or generic drugs, Adverse events due to use of FDC were collected and SPSS version 17 was used for statistical analysis. Fixed dose combinations were used in 90 Patients. The most commonly used FDC were ampicillin with Cloxacillin (43) followed by amoxicillin with clavulanic acid (22), cefoperazone with sulbactam (19) and piperacillin with tazobactam (6). A common drug used in combination along with FDC was metronidazole and aminoglycoside. The irrational combination seen in this study was ampicillin with Cloxacillin (8.88%) of the total FDC which is not approved by DCGI or FDA.

Results: In this study out of 145 drugs used, 41drugs were administered three times a day, 90 drugs were given two times a day and 14 drugs were given once a day dosing. 53 patients received FDCs for prophylaxis and 37 patients for treatment purpose. All FDCs were prescribed in brand names. No adverse drug reaction was observed in this study.

Conclusions: Consultants should undergo continuing medical education (CME) on newer drug combinations and their adverse drug reactions which will be evidence-based rather than to rely on representatives.

References

Gautam CS, Saha L. Fixed dose drug combinations (FDCs): rational or irrational: a view point. Br J Clin Pharmacol. 2008;65(5):795-6.

The selection and use of essential medicines-WHO technical report series: No.914; 2003:132. (Internet); cited 2014 Aug 18. Available at: http://apps.who.int/medicinedocs/en/d/Js4875e/5.2.html

Sreedhar D, Janodia MD, Ligade VS, Mohapatra S, Ganguly R, Udupa N Fixed dose combinations: Rational or irrational? Current science. 2008;95(5)10:581-2.

Tripathi KD. Antimicrobial drugs, Essentials of Medical Pharmacology. 7th Ed, 12. New Delhi, JAYPEE Brothers medical publishers; 2013:688-704.

Chambers HF, Sande MA. Antimicrobials: General considerations. In Hardman, JG and Limbird LE, (Eds) Goodman and Gilman’s. The pharmacological basis of therapeutics 8th ed. MC Graw Hill; 1996:1050-1053.

Woldu MA, Suleman S, Workneh N, Berhane H. Retrospective study of the pattern of antibiotic use in Hawassa University Referral Hospital Pediatric Ward, Southern Ethiopia; J App Pharm Sci. 2013;3(02):93-8.

Amane H, Priyadarshini K. Prescription analysis to evaluate rational use of Antimicrobials. International Journal of Pharma and Bio Sciences. 2011;2(2):314-9.

National List of Essential Medicines of India 2011 (internet); cited 2014 Aug 18. Available at: 2011http://www.cdsco.nic.in/writereaddata/National%20List%20of%20Essential%20Medicine-%20final%20copy.pdf

Brahma D, Marak M, Wahlang J. Rational Use of Drugs and Irrational Drug Combinations. The Internet J Pharmacology. 2012;10(1). (cited 2014 Aug 23). Available at: ISPUB.com/IJPHARM/10/1/14081

Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, et al. Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med. 1991;91(3B):152S-7S.

Haley RW. Nosocomial infections in surgical patients: Developing valid measures of intrinsic patient risk. American J Med. 1991;91(3):145-51.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27(2):97-132. quiz 133-4; discussion 96.

ASHP therapeutic guidelines. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health-Syst Pharm. 2013;70:624-709.

National Centre For Disease Control. National treatment guidelines for antimicrobial use in infectious diseases. Directorate General of Health Services, Ministry of Health and Family Welfare, Govt. of India; 2016:41.

Rehan HS. Surgical antibiotic prophylaxis in a tertiary care teaching hospital in India. Inter J Infec Control. 2010;6(2):1-6.

Downloads

Published

2018-11-24

How to Cite

R., V., & J., J. P. (2018). Prescribing pattern of fixed dose combinations of antibiotics in a post-operative surgical ward of tertiary care teaching hospital. International Journal of Basic & Clinical Pharmacology, 7(12), 2332–2335. https://doi.org/10.18203/2319-2003.ijbcp20184841

Issue

Section

Original Research Articles