Non-prescription sale of antibiotics in pharmacies across Puducherry, India

Background: Despite being illegal, non-prescription sales of antibiotics in India continue to be a major contributor to antibiotic abuse, which fosters antibiotic resistance.Methods: Two trained actors simulated symptoms of acute gastroenteritis (AGE) and upper respiratory tract infections (URTI) in 60 pharmacies each randomly selected in the Union Territory of Pondicherry, India. The ease of obtaining antibiotics, any additional enquiries made by the pharmacies, and any additional advise given were noted.Results: Only 33/120 pharmacies (27.5%) declined to dispense antibiotics without prescription; all 33 were attached to a hospital or nursing home. The most frequently dispensed antibiotics for AGE and URTI were ciprofloxacin (41.4%) and coamoxiclav (41.3%) respectively. Out of the 87 pharmacies which dispensed antibiotics without prescription, the presence of additional symptoms and previous drug allergy were enquired by 20 (22.9%) and 9 (10.3%) pharmacies respectively. While over half of the pharmacies gave instructions regarding dose, duration and frequency of antibiotic consumption, none of the pharmacies provided information regarding adverse reaction profile of antibiotics. Non-pharmacological measures for symptomatic improvement were advised by 24/120 pharmacies (20%).Conclusions: Non-prescription sales of antibiotics are unacceptably high in Pondicherry. Stricter implementation of the law and public awareness of the perils of inappropriate antibiotic usage are the need of the hour

A prospective study on adverse drug reactions reported in a tertiary referral hospital

Background: To determine the incidence of Adverse drug reactions in our hospital, to study the age wise distribution, the role of concurrent medication and the common drugs that are prone to cause adverse drug reactions and its seriousness.Methods: After getting prior approval from Institutional ethical committee a prospective study was done where in cases attending OPD, ward, ICU were studied over a year. A complete history was taken regarding drug exposure (dosage, date started, duration and interruptions in use), initiation of drug use and onset of reaction, previous adverse drug reactions, improvement after decrease in dosage, disease states predisposing to eruptions, previous family and personal history of skin disease, environmental and occupational exposure to chemicals. Relevant laboratory test such as blood investigations, liver and renal function tests are carried out and results were analysed statistically by SPSS version 21 and interpretations done based on the results.Results: Incidence of ADR among OPD =0.18, IPD=1.98, OPD+IPD=0.39 /1000cases.The highest incidence of Adverse drug reactions were found among the age group of 30-39 years (27.45%), 40-49 years (23.53%), with the highest among antibiotic group of drugs (35.29%) involving a maximum duration of 2-7 days. Drug reactions mostly occurred with the oral route 66.67) and most of it requiring hospitalization (47.06%), 60.78% of reactions were manifested in skin, 58.82% of patients with ADR had concomitant medications and 19.61% had Diabetes mellitus, 90% of reactions abated after drug withdrawal with regard to its outcome 94.12% of reactions recovered.Conclusions: The study suggest the adverse drug reactions commonly occur in middle age, mostly manifesting in skin with oral route of administration ,associated with concomitant medications and it requires hospitalisation with a good recovery rate with diabetes being the common comorbid disorder

Non-prescription sale of antibiotics in pharmacies across Puducherry, India

Background: Despite being illegal, non-prescription sales of antibiotics in India continue to be a major contributor to antibiotic abuse, which fosters antibiotic resistance.Methods: Two trained actors simulated symptoms of acute gastroenteritis (AGE) and upper respiratory tract infections (URTI) in 60 pharmacies each randomly selected in the Union Territory of Pondicherry, India. The ease of obtaining antibiotics, any additional enquiries made by the pharmacies, and any additional advise given were noted.Results: Only 33/120 pharmacies (27.5%) declined to dispense antibiotics without prescription; all 33 were attached to a hospital or nursing home. The most frequently dispensed antibiotics for AGE and URTI were ciprofloxacin (41.4%) and coamoxiclav (41.3%) respectively. Out of the 87 pharmacies which dispensed antibiotics without prescription, the presence of additional symptoms and previous drug allergy were enquired by 20 (22.9%) and 9 (10.3%) pharmacies respectively. While over half of the pharmacies gave instructions regarding dose, duration and frequency of antibiotic consumption, none of the pharmacies provided information regarding adverse reaction profile of antibiotics. Non-pharmacological measures for symptomatic improvement were advised by 24/120 pharmacies (20%).Conclusions: Non-prescription sales of antibiotics are unacceptably high in Pondicherry. Stricter implementation of the law and public awareness of the perils of inappropriate antibiotic usage are the need of the hour

A prospective study on adverse drug reactions reported in a tertiary referral hospital

Background: To determine the incidence of Adverse drug reactions in our hospital, to study the age wise distribution, the role of concurrent medication and the common drugs that are prone to cause adverse drug reactions and its seriousness.Methods: After getting prior approval from Institutional ethical committee a prospective study was done where in cases attending OPD, ward, ICU were studied over a year. A complete history was taken regarding drug exposure (dosage, date started, duration and interruptions in use), initiation of drug use and onset of reaction, previous adverse drug reactions, improvement after decrease in dosage, disease states predisposing to eruptions, previous family and personal history of skin disease, environmental and occupational exposure to chemicals. Relevant laboratory test such as blood investigations, liver and renal function tests are carried out and results were analysed statistically by SPSS version 21 and interpretations done based on the results.Results: Incidence of ADR among OPD =0.18, IPD=1.98, OPD+IPD=0.39 /1000cases.The highest incidence of Adverse drug reactions were found among the age group of 30-39 years (27.45%), 40-49 years (23.53%), with the highest among antibiotic group of drugs (35.29%) involving a maximum duration of 2-7 days. Drug reactions mostly occurred with the oral route 66.67) and most of it requiring hospitalization (47.06%), 60.78% of reactions were manifested in skin, 58.82% of patients with ADR had concomitant medications and 19.61% had Diabetes mellitus, 90% of reactions abated after drug withdrawal with regard to its outcome 94.12% of reactions recovered.Conclusions: The study suggest the adverse drug reactions commonly occur in middle age, mostly manifesting in skin with oral route of administration ,associated with concomitant medications and it requires hospitalisation with a good recovery rate with diabetes being the common comorbid disorder