International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(11), June, 2012

Pages: 13-16

Date of Publication: 18-Jun-2012


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ANALYSING RATES AND TRENDS OF ANTIBIOTICSPRESCRIPTION IN RURAL PARTS OF BHANDARA DISTRICT OF INDIA

Author: U.P. Chamat, S.W. Lohe, R. H. Fulzele

Category: Healthcare

Abstract:Study was carried out to find out the trends and rates of antibiotics prescribing by the physicians. Some patients and pharmacists were interviewed with prepared questionnaires. A study was conducted on the patients who are visiting to civil hospital, rural and primary health centers in Bhandara district. A total of 350 prescriptions were evaluated. For evolution of Prescriptions we follow the National list of essential medicine 2009 and Local guidelines for Prescription pattern. Among those 62.28 % of prescriptions were contain antibiotics and 37.72 % were not contain antibiotics. It indicates that the prescribing rate of antibiotics is higher. While evaluating prescriptions we observed that there were some common errors in prescribing antibiotic like, use of an antibiotics agents with inappropriate spectrum, unnecessary prescription of antibiotics, incorrect dosage and antibiotics were prescribed for viral infections that does not affect the viruses. This may leads to the development of antibiotic resistant bacterial population. Because of this some efforts should be made like, promotion of good Prescription practices, physicians should follow the local guidelines, design education programme for pharmacist, nurses & other professionals working in these settings.

Keywords: Spectrum, bacterial resistance, WHO (World Health Organization)

Full Text:

INTRODUCTION
Prescription is a written order from a registered medical practitioner or other property licensed practitioner to a pharmacist to compound and dispense a specific medication for the patient. While considering present scenario about the use of antibiotics many questions are arising in mind like, whether health care providers follow appropriate diagnostic procedure, also about the correct selection of products and dosage regimen to fit underlying heath problems? Whether they communicate with patient regarding proper label instructions, contraindications or dosage? . Common error in antibiotic prescription and misuse of antibiotics like, physicians not take into account the patients weight and history of prior antibiotics used. Since, both can strongly affect the efficacy of antibiotics. Prescribing inappropriate antibiotics like, use of antibiotic to the viral infections such as common cold that have no therapeutic effect. Dispensing of antibiotics over the counter because physicians prescribing same brands of an antibiotics. However this may leads to the development of antibiotic resistant bacterial population. Reapted and longer use of same brand of antibiotic leads to the emergence of resistant bacterial population which cannot be killed by that antibiotic this is known as antibiotic resistance. The existence of antibiotic resistance bacteria creates the danger of life threatening infections that do not respond to antibiotics.

METHOD
Present study was conducted by randomly collecting 350 prescriptions from patients visiting to different health care centers including civil hospitals, primary health care centers in rural and urban areas of Bhandara district. Patients and pharmacists get interviewed with prepared questionnaires, cross-sectional survey of prescription was done. National list of essential medicine 2009 and local guiding for prescription pattern was used as a reference for the evaluations of collected data.

RESULT
A total of 350 prescriptions were evaluated, where 63 Male, 111 Female, 113 Male Child & 63 Female Child. Evolution data suggests that 62.28 % of prescriptions were containing antibiotics among those 50.10% were in children and 37.72 % were not containing antibiotics indicating that prescribing rate of an antibiotics is higher. Physicians are commonly prescribing SEPTRAN, AMOX and DOXY in children and SEPTRAN, CIPRO, CIPROX, CIBRAN, CIFRAN, DOXY and AMOX in adults. While physicians in rural hospital and primary health centers are following the same trends. None of the drugs were prescribed in generic name. We observed that some antibiotics were prescribed for cold and Fever. Some patients and pharmacists were interviewed with prepared questionnaires from this we found that, prescriptions contain antibiotics with repeated brand name this may leads to the patients are purchasing antibiotics over the counter. Pharmacist are not guiding the patients regarding dosage and schedule of antibiotics administration. It may creates several problems like patients not completing their antibiotics course, skips the doses when they feel better and take same antibiotics next time without consulting to their physicians.

DISCUSSION AND CONCLUSIONS
While evaluating prescriptions we observed that Physicians are mostly prescribing SEPTRAN in children for COUGH, COLD, FEVER, RHINITIS, OTITIS, UTRI and SCABIES. SEPTRAN is followed by AMOX and DOXY. While SEPTRAN, CIPRO, CIPROX, CIBRAN, CIFRAN, AMOX, DOXY for COUGH, COLD, FEVER, RHINITIS, OTITIS, UTRI, SCABIES and ITCHING in adults. Physicians in rural hospital & primary health centers are following the same trend in adults and children. It is observed that none of the drugs were prescribed in generic name. After evaluating the prescriptions, we interviewed some patients and pharmacists. We found that patients are not following complete antibiotic therapy. They stop the antibiotics at midcourse, not follow proper schedule of the dose. It may leads to bacterial resistance and reinfection. There is repetition of antibiotics with same brand in the prescription.

This may leads to patients are taking antibiotics without consulting to their physicians. Some patients are demanding and purchasing antibiotics over the counter. Hence some useful tips need to be given by physicians/pharmacist to their patients:-

  • Take an antibiotic exactly as the physician/pharmacist tells you.
  • Do not skip the doses of antibiotics.
  • Do not take antibiotics for a viral infection like a cold or flu.
  • Complete the prescribed course of treatment even if you feel better.
  • Do not take antibiotics prescribed for someone else. The antibiotic may not be appropriate for your illness. Taking the wrong medicine may delay the effect of correct treatment and leads to bacterial resistance.
  • Do not purchase an antibiotic over the counter. Do not ask your pharmacist for antibiotics without prescription.
  • Talk to your healthcare professionals about antibiotics resistance.

There are some errors made by physician while prescribing antibiotics like use of antibiotics for viral infections such as common cold and fever which does not affect the virus. Antibiotic being prescribed with improper dosage administration with meal or without meal which affect the absorption of the drug and in turn decrease the bioavailability of drug. One of the foremost concerns in modern medicine is antibiotic resistance. If antibiotics are stopped in midcourse, the bacteria may be partially treated and not completely killed, causing the bacteria to be resistant to the antibiotic. Those resistant bacteria grow enough to cause the re-infection. Because of this alarming prevalence of bacterial resistance some efforts should be made like.

  • Document the infection microbiologically before starting an antimicrobial therapy.
  • Consider the weight and prior history of antibiotics used.
  • Avoid use of certain antibiotics already known to be associated with emergence of bacterial resistance.
  • Promotion of good prescribing practices.
  • Streaming broad spectrum therapy.
  • Adhere to the local guidelines.
  • Prescribe the antibiotics with their generic name.
  • Counseling with the patients

To improve the quantity of antibiotic use in hospitals, a multidisciplinary antimicrobial committee should be formed, which would be composed of physicians, microbiologist and the pharmacists etc. Teaching and training about antimicrobial therapy for doctors, nurses, pharmacists and undergraduate medical and pharmacy students.

ACKNOWLEDGEMENT
Thanks to the community pharmacist who helped us to carry out this survey, thanks to patients and Anurag College of pharmacy Warthi for providing necessary literatures. Authors are grateful to Mr. Ajay Pise and Sandeep Rahangdale for his guidance. Authors acknowledge the immense help received from the scholars whose article has cited and included in reference of this manuscripts. Thanks to the editor, reviewers of IJCRR Journal Management team.

References:

1. Dr. K.R. Mahada Dr. B.S. Kuchekar. Concise organic pharmaceutical chemistry page no 4.1 –4.20 .

2. L. Pachuau, L. Chhani, T. Jamir. Indian journal of hospital pharmacy, 48(2011) page no. 38- 39.

3. Ansari K.U. Signh, S. Pandey. Evaluation of prescription pattern of doctor for rational drug therapy Indian Journal of Pharmacol, 1998: 30 ,page no.43- 46.

4. S. Ponnusankar, M. Chintan, S. Karthikayen, B. Suresh. Indian journal of hospital pharmacy Sept- Oct.2007 pg no. 181 – 183.

5. S. Ponnusankar B. Suresh. Indian journal of hospital pharmacy, July- Aug2007 page no. 145-152.

6. A. Kaur & Dr. B, G. Nagavi. Indian journal of hospital pharmacy Marchapril -2007, page no. 72- 74.

7. National list of essential drugs 2009 page no 1-43. 8. Local guidelines for prescription pattern.

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
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A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
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A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
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A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
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A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
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A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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