PATTERNS OF PRESCRIPTION AND ANTIBIOTIC USE AMONG OUTPATIENTS IN A TERTIARY CARE TEACHING HOSPITAL OF BANGLADESH

Authors

  • Sumon Kumar Datta Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh
  • Tripti Rani Paul Department of Pharmacy, Varendra University, Rajshahi, Bangladesh
  • Monalisa Monwar Department of Pharmacy, Varendra University, Rajshahi, Bangladesh
  • Ambia Khatun Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh
  • M. Rafiqul Islam Department of Pharmacy, Jessore University of Science and Technology, Jessore, Bangladesh
  • M. Ashraf Ali Department of Pharmacy, Mawlana Bhasani Science and Technology University, Tangail, Bangladesh
  • Ranjan Kumar Barman Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh
  • Bytul Mokaddesur Rahman Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh
  • Mir Imam Ibne Wahed Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh

DOI:

https://doi.org/10.22159/ijpps.2016v8i11.9827

Keywords:

Prescription pattern, Irrational drug use, Polypharmacy, Prescribing indicators, Antibiotics, NSAIDS

Abstract

Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh.

Methods: This prospective survey was conducted among the out-patients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to world health organisation (WHO).

Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%).

Conclusion: Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients.

Downloads

Download data is not yet available.

References

Melrose D. Double’ deprivation public and private drug distribution from the perspective of the third world's poor. World Dev 1983;11:181-6.

WHO. Introduction to Drug Utilization Research; 2003. p. 1-48.

Dinesh KG, Padmasani L, Vasantha J, Veera RB, Sudhkar P, Uma MR. The official journal of association of pharmaceutical teachers of India. Indian J Pharm Prac 2011;4:85-9.

Bapna JS, Shewade DG, Pradhan SC. Training medical professionals on the concepts of essential drugs and rational drug use. Br J Clin Pharmacol 1994;37:399-400.

Mohanty BK, Ashwini M, Hasamnis AA, Patil SS, Murty KSN, Jena SK. The prescription pattern in the department of medicine of a tertiary care hospital in Rajamundry, India. J Clin Diag Res 2010;4:2047-51.

WHO. World Health Organization medicine strategy; 2008-2013.

Faryna A, Wergowske GL, Goldenberg K. Impact of therapeutic guidelines on antibiotic use by residents in primary care clinics. J General Internal Med 1987;2:102-7.

Padmaja U, Adhikari P, Pereira P. A prospective analysis of adverse drug reactions in a South Indian hospital. Online J Health Allied Sci 2009;8:12.

Banglapedia (National Encyclopedia of Bangladesh). Rational Use of Drugs Multimedia. 1st Edition. Asiatic Society of Bangladesh, Dhaka; 2004.

Hossain MM, Glass RI, Khan MR. Antibiotic use in a rural community in Bangladesh. Int J Epidemiol 1982;11:402-5.

Gustafsson LL, Wide K. Marketing of obsolete antibiotics in central America. Lancet 1981;1:31-3.

Ratanawijitasin S. Drug users in Thailand: identifying problems and developing strategies for rational use of drugs. INRUD News 1996;6:21.

Kunin CM, Lipton HL, Tupasi T, Sacks T, Sheckler WE, Jivani A, et al. Social, behavioural and practical factors affecting antibiotic use worldwide. Rev Infect Dis 1987;9:270-85.

Fedorak RAA, Flamm R, Osato M, Stamler D. Antimicrobial susceptibility of H. pylori in Canada to three key antibiotics: metronidazole, clarithromycin, and amoxicillin. Gastroenterology 1997;112:115.

Nahar S, Mukhopadhyay AK, Khan R, Ahmad MM, Datta S, Chattopadhyay S, et al. Antimicrobial susceptibility of Helicobacter pylori strains isolated in Bangladesh. J Clin Microbiol 2004;42:4856-8.

Tognoni G, Laporte JR. From clinical trials to drug utilisation studies. In: Drug utilisation studies Methods and uses. Dukes MNG. ed. Copenhagen, WHO regional office for Europe; 1993. p. 23-41.

Ali HM. Problems in assessing the rationality of drug utilisation in less developed countries. Acts Med Scand 1986;721 Suppl 1:27-30.

Biswas NR, Jindal S, Siddiqui MM, Maini R. Patterns of prescription and drug use in ophthalmology in a tertiary hospital in Delhi. Br J Clin Pharmacol 2001;51:267-9.

Laporte JR. Towards a healthy use of pharmaceuticals. Deployment Dialogue 1995;2:48-55.

Gross F. Drug utilisation therapy and practice: The present situation in the Federal Republic of Germany. Eur J Clin Pharmacol 1981;19:387-94.

Biswas NR, Jindal S, Siddiqui MM, Maini R. Patterns of prescription and drug use in ophthalmology in a tertiary hospital in Delhi. Br J Clin Pharmacol 2001;51:267-9.

Hede SS, Din RS, Agshiker NV, Dhume VG. The pattern of prescribed and OTC drugs in North Goa. Indian J Pharmacol 1987;19:145-8.

Sultana F, Rahman A, Paul TR, Sarwar MH, Islam MA, Rashid M. Prescribing pattern and prescription errors: a study at a tertiary care hospital of Bangladesh. Ban Pharm J 2015;18:20-4.

Atanasova I, Terziivanov D. Investigations on antibiotics in a hospital for a one year period. Int J Clin Pharm Ther 1995;33:32-3.

Till B, Williams L, Oliver SP, Pollans PI. A survey of inpatient antibiotic use in a teaching hospital. S Afr Med J 1991;8:7-10.

Lamichhane DC, Giri BR, Pathak OK, Panta OB, Shankar PR. Morbidity profile and prescribing patterns among outpatients in a teaching hospital in Western Nepal. Mcgill J Med 2006;9:126-33.

Indira KS, Chandy SJ, Suresh L. Antimicrobial prescription patterns for common acute infections in some rural and urban health facilities of India. Indian J Med Res 2008;128:165-71.

Hart CA, Kariuki S. Antimicrobial resistance in developing countries. Br Med J 1998;317:647-50.

Snellman L, Adams W, Anderson G, Godfrey A, Gravley A, Johnson K, et al. Institute for Clinical Systems Improvement. Diagnosis and Treatment of Respiratory Illness in Children and Adults; 2013. p. 1-86.

Shankar RP, Partha P, Shenoy NK, Easow JM, Brahmadathan KN. Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study. Ann Clin Microbiol Antimicrob 2003;16:7.

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

Karabay O, Ozdemir D, Guçlu E, Yıldırım M, Ince N, Kuçukbayrak A, et al. Attitudes and behaviours of family physicians regarding the use of antibiotics. J Microbiol Infect Dis 2011;1:53-7.

Mamun KZ, Tabassum S, Shears P, Hart CA. A survey of antimicrobial prescribing and dispensing practices in rural Bangladesh. Mymensingh Med J 2006;15:81-4.

Bequi AH, Black RE, El Arifeen S, Yunus M, Zaman K, Begum N, et al. Therapy of diarrhea increased the use of oral rehydration therapy and reduced the use of antibiotics in Bangladeshi children. J Health Population Nutr 2004;22:440-2.

Published

01-11-2016

How to Cite

Datta, S. K., T. R. Paul, M. Monwar, A. Khatun, M. R. Islam, M. A. Ali, R. K. Barman, B. M. Rahman, and M. I. I. Wahed. “PATTERNS OF PRESCRIPTION AND ANTIBIOTIC USE AMONG OUTPATIENTS IN A TERTIARY CARE TEACHING HOSPITAL OF BANGLADESH”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 8, no. 11, Nov. 2016, pp. 60-63, doi:10.22159/ijpps.2016v8i11.9827.

Issue

Section

Original Article(s)

Most read articles by the same author(s)