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Evalution of the rationality and cost comparison of fixed dose combinations of antibiotics in a tertiary care hospital
Corresponding Author(s) : V. Shivashankar
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 3 No. 2 (2015): 2015 Volume 3- Issue -2
Abstract
The development of fixed-dose combinations (FDCs) is becoming increasingly important from a public health perspective. Such combinations of drugs are being used in the treatment of a wide range of conditions. The use of fixed dose combinations of antibiotics is more prevalent in the recent years. The FDC antibiotic use must be limited because; a single antibiotic can be used effectively in most infections caused by a single organism. Furthermore, a single wide-spectrum antibiotic may be used in many mixed infections. The main objective of the study was to assess the prescription pattern and rationality of Fixed Dose Combinations of antibiotics using seven- point criteria. A Prospective- Observational Study was conducted among 102 patients for 9 months. The data from the cases were evaluated. The FDCs prescribed were thoroughly analyzed by seven point criteria to evaluate the rationality. The demographics of study population showed that male population was predominant. The diagnosis study population revealed that major infections were LRTI (26%) and UTI (20%). The culture sensitivity test was performed in 31.3% of study population to choose the appropriate antibiotic. The results of culture sensitivity tests showed that the most commonly isolated organisms were E.coli and S.pneumonia. A total number of 455 drugs were prescribed in the study population from which 22% were identified as FDC antibiotics. The commonly prescribed FDCs was Pipercillin+Tazobactum accounting for 34%. The seven point criteria analysis reveals 5 out of 8 FDCs were cost effective than their individual components and were rationally prescribed. By studying and comparing all the evidences obtained, the study concludes that the utilization of FDCs in the study site was found to be rational.
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[1] Ganguly NK, Arora NK, Chandy SJ, Fairoze MN, Gill JP, Gupta U, et al. GARP-India working group. Rationalizing antibiotic use to limit antibiotic resistance in India. Indian J Med Res. 2011;134:281–94.
[2] Williams A, Mathai AS, and Phillips AS.Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. J Pharm Bioallied Sci.2011; 3(4): 531–536.
[3] Kishore SK, Sushil A ,Arun G, Suresh P. Fixed dose combinations : survival or disposal; Novel Science International Journal of Pharmaceutical Science 2012 , 1(2) : 115-124.
[4] Ganguly NK.Rationalizing antibiotic use to limit antibiotic resistance in India: Indian J Med Res.2011; 281-294.
[5] Sen A. Indian Market’s Fixation with Fixed Dose Combinations. Rational Drug Bulletin. 2002, 12 (1): 1-2.
[6] Panda J, Tiwari P, Uppal R. Evaluation of the rationality of some FDCs: Focus on antihypertensive drugs. Indian journal of pharmaceutical sciences. [Internet]. 2006 [cited 2011 January 17]; 68(5):647-648. Available from: http://www.ijpsonline.com
[7] Akram Ahmad, S. Parimalakrishnan, Guru Prasad Mohanta , Isha Patel and PK Manna . A study on utilization pattern of higher generation antibiotics among patients visiting community pharmacies in chidambaram International Journal of Pharmacy 2012; 2(3):466-471.
[8] Balasubramaniam R, Hariharan D, Pamulapat T. V, Devaraja V, and Shanmugam S. A Study on Evaluation of Rationality of Fixed Dose Combinations;Am. J. PharmTech Res. 2013; 3(5).
[9] Preetha M, Shobana J. Study on prescribing patterns of antibiotics used in the management of various infectious diseases in Andhra Pradesh. International research journal of pharmacy 2011; 2(7):112-115.
[10] Neetesh K Jain , A Akarte , Pradeep T Deshmukh , Pushpendra Kannojia , Navneet Garud , Yadav Akash .Rationality of fixed dose combinations: An Indian Scenario. The Pharma Research year: 2009, vol:01.
[11] Kadir Alam, Arjun Poudel, Subish Palaian, et al.. Fixed dose combination antimicrobials practices in Nepal –review of literature. Journal of Clinical and Diagnostic Research 2010; 4:3255-3260.
[12] Poudel A, Palaian S, Shankar P R, Jayasekera J, Izham M I M. Irrational fixed dose combinations in Nepal: Need for intervention. Kathmandu university medical journal. 2008; 6(3)23:399-405.
References
[2] Williams A, Mathai AS, and Phillips AS.Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. J Pharm Bioallied Sci.2011; 3(4): 531–536.
[3] Kishore SK, Sushil A ,Arun G, Suresh P. Fixed dose combinations : survival or disposal; Novel Science International Journal of Pharmaceutical Science 2012 , 1(2) : 115-124.
[4] Ganguly NK.Rationalizing antibiotic use to limit antibiotic resistance in India: Indian J Med Res.2011; 281-294.
[5] Sen A. Indian Market’s Fixation with Fixed Dose Combinations. Rational Drug Bulletin. 2002, 12 (1): 1-2.
[6] Panda J, Tiwari P, Uppal R. Evaluation of the rationality of some FDCs: Focus on antihypertensive drugs. Indian journal of pharmaceutical sciences. [Internet]. 2006 [cited 2011 January 17]; 68(5):647-648. Available from: http://www.ijpsonline.com
[7] Akram Ahmad, S. Parimalakrishnan, Guru Prasad Mohanta , Isha Patel and PK Manna . A study on utilization pattern of higher generation antibiotics among patients visiting community pharmacies in chidambaram International Journal of Pharmacy 2012; 2(3):466-471.
[8] Balasubramaniam R, Hariharan D, Pamulapat T. V, Devaraja V, and Shanmugam S. A Study on Evaluation of Rationality of Fixed Dose Combinations;Am. J. PharmTech Res. 2013; 3(5).
[9] Preetha M, Shobana J. Study on prescribing patterns of antibiotics used in the management of various infectious diseases in Andhra Pradesh. International research journal of pharmacy 2011; 2(7):112-115.
[10] Neetesh K Jain , A Akarte , Pradeep T Deshmukh , Pushpendra Kannojia , Navneet Garud , Yadav Akash .Rationality of fixed dose combinations: An Indian Scenario. The Pharma Research year: 2009, vol:01.
[11] Kadir Alam, Arjun Poudel, Subish Palaian, et al.. Fixed dose combination antimicrobials practices in Nepal –review of literature. Journal of Clinical and Diagnostic Research 2010; 4:3255-3260.
[12] Poudel A, Palaian S, Shankar P R, Jayasekera J, Izham M I M. Irrational fixed dose combinations in Nepal: Need for intervention. Kathmandu university medical journal. 2008; 6(3)23:399-405.