Drug Utilization Evaluation of Antibiotics used in Vulnerable Population at Selected Tertiary Care Hospital in Andhra Pradesh
Author(s): Amit Kumar*, S K Panda, Divya S Nair, Padala Srilakshmi and Sruthi Sreenivasan
Aim: To determine drug utilization evaluation (DUE) of antibiotics used in vulnerable populations at selected tertiary care hospital in Andhra Pradesh.
Materials and methods: This prospective study was carried out among 551 patients (vulnerable population pediatrics, pregnant women, geriatrics and other vulnerable patients) from a selected tertiary care hospital. Based on Modified Kuppuswamy socio economic status scale 2020 our study population was under lower middle, upper lower and lower class. In our study the ratio of prescribed daily dose (PDD) to WHO defined daily dose (DDD) and DOT calculation (for pediatrics) was used for drug utilization evaluation. Cost comparison study was also conducted between the prescribed branded antibiotics and their generic alternative.
Results: The study included 551 patients; males were in majority when compared to females. Cephalosporins were the most commonly prescribed antibiotics in patients: Pediatrics (46.74%), pregnant women (80.55%), Geriatric (49.76%) and other patients (42.99%). Most commonly prescribed antibiotic combinations were Amoxicillin-Clavulanate (3.63%) in oral formulation, Piperacillin-Tazobactam (4.63%) and Sulbactam- Cefoperazone (2.38%) in parenteral formulation. DOT calculation was done for pediatric patients which revealed association of days of therapy with therapeutic outcome. The PDD/DDD ratio revealed more sub use of antibiotics, followed by overuse and least optimal drug utilization. Prescriptions for branded antibiotics were more (81.13%) when compared to generics. Based upon AWaRe classification of antibiotics majority of antibiotics were from Watch group (73.63%). Cost comparison studies showed branded antibiotics are costlier than their alternative generic counterparts with a total mean difference of ₹665.40.
Conclusion: The study indicates that there is lot of scope of improvement in prescribing pattern of antibiotics when practicing rational drug use. Optimized antibiotic prescription is required in geriatric, pediatric and pregnant women, to prevent overuse and subuse of antibiotics in order to prevent bacterial resistance and adverse drug reaction associated with inappropriate antibiotic usage. More of Generic antibiotics should be prescribed and dispensed to reduce the cost burden on patients. Parenteral therapy should be prescribed only when necessary. Culture and sensitivity tests should be mandatory for antibiotics prescription to get more appropriate therapeutic outcome.