USAGE OF ANTIMICROBIALS IN POST-OPERATIVE PATIENTS IN A TERTIARY CARE TEACHING RURAL HOSPITAL IN INDIA

Chaudhary K Pankaj*, Dr. Jain Atul, Dr. Maurya K Arvind, Dr.Gaurav, Dr. Mishra Ajitesh

ABSTRACT

Background: Rational antibiotic usage reduces the incidence of Post surgical wound infection but its improper usage can further lead to excessive surgical wound infection and increased drug resistance which further complicates the problem. Proper treatment of postoperative and other hospital acquired infections is essential. Hence to investigate the current scenario in surgical post-operative patients, the present study was undertaken. Objectives: The objective of this study was to assess the current trends of prescribing antibiotics amongst the patients of surgical postoperative unit of UP Rural Institute of Medical sciences and Research, India. Materials and Methods: A descriptive retrospective study was done amongst the patients admitted in the surgical postoperative ward of UP RIMS & R, Saifai, Etawah, India. This study was done by collecting the prescriptions during the months between January 2015 to March 2015. The study was conducted in accordance with the ethical principles of the ethics committee guidelines. We collected data from 142 postoperative patients. Information was collected with respect to Demographic profile, most common case diagnosed, commonly prescribed antibiotics and WHO core indicators were assessed from the inpatients records. Data were analyzed using Microsoft Office Excel 2007 and values were presented descriptively in percentiles. Results: We analyzed the data using the various drug use indicators given by the WHO. The average number of drugs per encounter was 4.98. The most common surgeries in the postsurgical unit were hydrococle 41 followed by Gynecological 32. Most of the patients were in the age group of 31-40 yrs. Most commonly prescribed antibiotic were cephalosporin's (35%) followed by Amminoglycosides (24%). Out of 1250 drugs prescribed, 851(68%) drugs were prescribed by generic names and drugs prescribed by their brand names were 399(32%). Drugs on WHO EML were 61% while that of NLEM 2011 were 74%. Dosage forms used as injectables 91.28% (1141/1250). Fixed dose combinations were prescribed in 36.88% (461/1250) prescriptions. Average cost per prescription was 866.40 INR. Conclusion: The present study provides valuable insight about the overall pattern of drug used in postoperative patients in a tertiary care hospital. It is intended to be a step in broader evaluation of safety and efficacy of drug as well as for improving prescribing habits among the fraternity and minimizing incidence of resistance to antimicrobials in surgical wards of a teaching hospital.

Keywords: Antimicrobials, post-operative, surgical ward.