ASSESSMENT OF DRUG UTILIZATION AMONG PEDIATRIC PATIENTS IN PRIVATE CLINIC AND PUBLIC HOSPITAL OF BANGLADESH

Objective: Aim of the study was to assess drug utilization among pediatric patients in both private practice and hospital settings in Rajshahi city, Bangladesh. Methods: This observational study was conducted during a period of two months (March to April) in 2017. Prescriptions were randomly collected from patients and recorded in a predesigned questionnaire form. The data analysis was carried out by using a statistical software package GraphPad Prism. Results: The study involved a total of 185 patients, of which 62.70% were male and 37.30% were female. The patient’s age ranges from 1 mo-12 y and highest number of patients visited physicians belong to group 1 mo-1 y (47.57%). Most commonly occurring disease conditions were pneumonia (24%), the leading cause of hospitalizations among the children's age group of 1 mo-1 y. The results indicated that physician’s handwriting was not clear and legible in 50 (27.03%) prescriptions. A total of 468 drugs were prescribed with an average of 2.53 per prescription. However, none of the drugs were prescribed by generic name. The most commonly prescribed drugs were antibiotics 173 (93.5%). About 78% patients were exposed to antibiotics, of which single antibiotic was prescribed in 116 (62.70%) and two antibiotics in 23 (12.43%) prescriptions. Among the drugs, NSAIDS 65 (35.14%), anti-histamine 57 (30.81%), anti-asthmatic 49 (26.49%) drugs were assigned in prescriptions followed by vitamin and minerals 51 (27.57%). Steroids 57 (30.81%) and hypnotics 26 (14.05%) were also accounted in many prescriptions. Interestingly, antibiotics were indiscriminately prescribed in private practices without any bacteriological examinations, whereas in hospital settings, most of the treatment was initiated after culture and sensitivity tests. Conclusion: Children were highly exposed to antibiotics, steroids and hypnotics in both private practice and hospital settings.  So Medical practitioners should be aware of current guidelines for prescriptions of antibiotics and drugs in child

PATTERNS OF PRESCRIPTION AND ANTIBIOTIC USE AMONG OUTPATIENTS IN A TERTIARY CARE TEACHING HOSPITAL OF BANGLADESH

Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh.Methods: This prospective survey was conducted among the out-patients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to world health organisation (WHO).Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%).Conclusion: Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients