DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170953

Drug prescribing pattern in acute gastroenteritis in an in-patient setting in a private hospital

Nachiket Bhaveshaikh, Sangita Sukumaran, Upal Vyas

Abstract


Background: Diarrheal diseases cause significant morbidity in developing countries and are the leading cause of death in children. The study was undertaken to assess drug utilization patterns in patients with gastroenteritis in a private setting.

Methods: The in-patient data records of 208 patients (96 males, 112 females) admitted with acute gastroenteritis in a private hospital in Mumbai over 2 years were analysed. WHO core drug prescribing indicators - average number of drugs per prescription, percentage of drugs prescribed by generic name, percentage of encounters resulting in prescription of an antibiotic, percentage of encounters resulting in prescription of an injection were assessed. Patient demographics and trends in use of antibiotics, antiemetics and antidiarrheals were assessed.

Results: The average total number of drugs prescribed per patient was 6.33 and average number of antibiotics was 1.61. 99% of drugs were prescribed using brand names. Percentage of encounters resulting in prescription of injection was 97.11%. Cephalosporins were the most commonly used group of antimicrobials (62.5%) followed by fluroquinolones (49.03%) and antiamoebic drugs (35.58%). Diphenoxylate was the most commonly prescribed antidiarrheal drug and ondansetron was the most commonly prescribed antiemetic agent. Cephalosporins were the most commonly used antimicrobials in patients diagnosed with enteric fever.

Conclusions: Emperical irrational use of antibiotics was observed. There was paucity of stool culture for identification of causative agents. Review of antibiotic susceptibility patterns needs to be done on a regular basis. Educational programmes to reinforce the need for ORS and zinc supplementation are necessary.

 


Keywords


Antimicrobials, Gastroenteritis

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References


Pahwa S, Kumar GT, Toteja GS. Performance of a Community-based Health and Nutrition-education Intervention in the Management of Diarrhoea in a Slum of Delhi, India. J Health Popul Nutr. 2010;28(6):553-9.

Farthing M, Salam MA, Lindberg G, Dite P, Khalif I, Salazar-Lindo E, et al. World Gastroenterology Organisation Global Guidelines Acute diarrhea in adults and children: a global perspective. J Clin Gastroenterol. 2013;47(1):12-20.

Baldi F, Bianco MA, Nardone G, Pilotto A, Zamparo E. Focus on acute diarrhoeal disease. World J Gastroenterol. 2009;15(27):3341-8.

Chowdhury F, Khan IA, Patel S, Siddiq AU, Saha NC, Khan AI, et al, Diarrheal Illness and Healthcare Seeking Behavior among a Population at High Risk for Diarrhea in Dhaka, Bangladesh. PLoS ONE 10(6): e0130105.

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

Turck D, Berard H, Fretault N, Lecomte JM. Comparison of racecadotril and loperamide in chldren with acute diarrhea. Aliment phamracol Ther. 1999;13(suppl 6):27-32

Wang HH, Shieh MJ, Liao KF. A blind, randomized comparison of racecadotril and loperamide for stopping acute diarrhea in adults. World J Gastroenterol. 2005;11(10):1540-3.

Walker CLF, Black RE. Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity, mortality and incidence of future episodes. Int J Epi. 2010;39:i63-9.

Lamberti LM, Fischer Walker CL, Taneja S, Mazumder S, Black RE. The Association between Provider Practice and Knowledge of ORS and Zinc Supplementation for the Treatment of Childhood Diarrhea in Bihar, Gujarat and Uttar Pradesh, India: A Multi-Site Cross- Sectional Study. PLoS ONE. 2015. 10(6): e0130845.

Schiff GD, Wisniewski MF. Improving Inpatient Antibiotic Prescribing: Insights from Participation in a National Collaborative. J quality improvement. 2001;27(8):387-402.

Javato-Laxer M. Antimicrobial prescribing patterns in hospital: Determinants and proposed interventions. Phil j microbial infectious diseases. 1989;18 (2):41-6.