Assessment of antimicrobial prescription patterns of doctors in Combined Military Hospital Sialkot

Abstract

Objective: To assess drug use practices and antibiotic prescribing pattern using WHO drug use indicators and to observe trends of prescribing broad spectrum & narrow spectrum antibiotics.

Study design: Descriptive case series study.

Place and durtion setting: Study was conducted at Combined Military Hospital, Sialkot from April 2015 to May 2015.

Patients and Methods: Non probability convenient method sampling technique was used to select 1000 random prescriptions from various departments with or without antibiotics Specialists from 5 departments were also interviewed by using questionnaire. These were from medical, dermatologyt, paediatrics, ophthalmology and otolaryngology departments. Treatment chits of patients ranging from age   6 months to 80 years of either gender were included in study.  Treatment chits of children below 6 months, geriatrics above 80 years, pregnant females and patients suffering from hypertension, diabetes mellitus, ischemic heart disease were excluded from study. Parameters measured were WHO core prescribing indicators, basic prescribing information, basic patient information and percentage of various classes of antibiotics.

Results: 507 (50.7%) prescriptions were of males and 493 (49.3%) were from female patients. The mean age was 30.95 +_ 22.63 (S.D) years. Age ranged from 6 months to 76 years. 468(46.8%) prescriptions were encountered with antibiotics whereas 532(53.2%) prescriptions did not contain any antibiotic. Maximum antibiotics were prescribed in Eye OPD (25%) and ENT OPD (24.77%) followed by 23 %, 16 % & 10% in paediatrics, medicines and dermatology OPDs respectively. 

Conclusion: Generic prescribing and polypharmacy were parameters found to be problematic. Prescribing appropriateness for some of the antibiotics should be checked through Drug use evaluation. Culture sensitivity tests should be conducted where required, to avoid antibiotic resistance. Antibiotic policy must be implemented.

Keywords: Antimicrobial prescription, WHO indicators, Assessment of patterns of drugs -Hodgkin Lymphoma, Trephine biopsy, Immunohistochemistry (IHC).