Comparative Study Analysis and Rationality Assessment of Antibiotics in General Medicine Department of a Tertiary Level Teaching Hospital in South India

Abstract

Rational use of medicines requires that "patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community". Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly? The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. Examples of irrational use of medicines include: use of too many medicines per patient ("poly-pharmacy"); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines. The aim of the research is to study the comparative study analysis and to determine the Rational / Irrational use of antibiotics in a tertiary care hospital along with its beneficial and adverse outcomes and to Intervene strategies from pharmacist perspective to promote rational use of antibiotics to improve therapeutic outcomes in patients thereby improving quality of life (QOL) of patients. The study was carried out for a period of 24-36 months in Shadan Institute of Medical Sciences, Shadan Hospital, Hyderabad. It is a single centered, prospective observational study. Subjects of both genders who indicated with antibiotic therapy are taken in our study. On assessment, in a total of 3685 patients, it was concluded that, 1565 cases were male, 2120 cases were female, 1425 patients were Literates, 2260 patients were Illiterates, 1060 patients belongs to Low class, 1645 patients belongs to Middle class and 980 patients belongs to High class. In a total of 3685 prescriptions, it was concluded that, 2594 prescriptions (71%) were rationally prescribed and 1091 prescriptions (29%) were prescribed irrationally. In a total of 4700 antibiotics, it was concluded that, Prescriptions with single antibiotic are 1856, accounted for 39%, Prescriptions with 2 antibiotics are 2004, accounted for 44% and Prescriptions with 3 antibiotics are 840, accounted for 17%.In a total of 4700 antibiotics, it was concluded that, Cephalosporins (1420 antibiotics) were found to be highly prescribed antibiotic category accounted for 30.21%. Aminoglycosides (548 antibiotics) accounted for 11.65%, Macrolides (1165 antibiotics) accounted for 24.78%. Quinolones (902 antibiotics) accounted for 19.19%. Penicillins (385 antibiotics) accounted for 8.19% and Tetracyclines (278 antibiotics) accounted for 5.91%. There is a need of educational programs to promote rational use of antibiotics.