ASSESSMENT OF ADVERSE DRUG REACTIONS OCCURRING AT DEPARTMENT OF NEUROLOGY OF A TERTIARY CARE HOSPITAL IN INDIA

Objective: The purpose of this study was to assess the incidence and pattern of adverse drug reactions (ADRs) reported from the department of neurology of a tertiary care hospital in Karnataka, India.Methods: It is a hospital-based prospective, observational study, conducted among the inpatients of all age groups of either sex for a period of 6 months. ADRs were reported by the clinical pharmacists and physicians of this hospital. ADRs obtained were categorized based on its causality, severity, preventability, predictability, and outcomes. Binary logistic regression was carried out to identify the predictors of ADR and Kaplan–Meier analysis was performed for survival analysis.Results: A total of 250 patients were enrolled for the study in which 108 (43%) patients were presented with at least one ADR and a total of 212 ADRs were observed. The highest rate of ADRs was observed with antiepileptics 61 (29.5%). The most commonly reported that ADRs were skin reactions 23 (10.8%). Causality was assessed using three different scales which showed that most of the ADRs were probable. Severity, preventability, and predictability were assessed, of which 125 (59%) ADRs were moderate, 192 (90.6%) ADRs were probably preventable, and 156 (73.6%) ADRs were predictable, respectively. The outcomes showed that 150 (70.1%) patients recovered from the reactions. Predictors such as polypharmacy and duration of stay were found to be significant.Conclusion: The study concluded that the prevalence of ADRs in the department of neurology is high. Thus, early detection and management of ADRs are essential to avoid further complications of the reaction

Predictors of adverse drug reactions in geriatric patients: An exploratory study among cancer patients

Objectives: The objective of this study was to study the predictors of adverse drug reactions (ADRs) among geriatric patients in the Department of Medical Oncology. Methods: A hospital-based prospective observational study was carried out among 153 inpatients in the Department of Medical Oncology for 6 months. Patients above 60 years of age with a confirmed history of malignancy were included in the study. The potential risk factors for ADR were defined in relation to the patient and chemotherapeutic regimen and relationship between them was assessed by univariate and multivariate logistic regression analysis. Results: Among 153 patients, 94 (64.43%) experienced ADRs. The mean ADR per patient was 0.88 ± 1.2. The common ADRs found were alopecia (30.18%) and diarrhea (28.68%). Risk estimates revealed that there was a significant association between smokers (odds ratio [OR] = 10.326; 95% confidence interval [CI] 2.345–45.47, P = 0.001), alcoholics (OR = 10.897; 95% CI 2.479–47.902, P = 0.001), increasing age (OR = 2.22; 95% CI 1.698–2.909, P = 0.001), overweight (OR = 16.68; 95% CI 2.179–127.741, P = 0.001), and male participants (OR = 0.143; 95% CI 0.05–0.390 P = 0.001) with the development of ADRs. The risk of carboplatin (OR = 13.359; 95% CI 3.056–58.406 P = 0.001) and 5-fluorouracil (OR = 1.938 95% CI 1.266–2.935 P = 0.001) use and occurrence of ADRs were also found to be high. Conclusion: The study findings showed that smoking, alcohol consumption, age more than 70 years, and overweight had a high risk for developing ADRs in geriatric patients who underwent chemotherapy. The independent risk factors identified should be targeted for preventive measures to improve anticancer agent prescription and reduce the risk of ADRs

Predictors and patterns of empirical antibiotic therapy and associated outcomes in COVID-19 patients: a retrospective study in a tertiary care facility in South India

The coronavirus disease (COVID-19) led to a global health crisis. Inappropriate use of antibiotics in COVID-19 patients has been a concern, leading to antimicrobial resistance. This study evaluated the patterns and predictors of empirical antibiotic therapy in COVID-19 patients and associated outcomes. A hospital-based retrospective study was conducted with 525 patients admitted to Kasturba Hospital, Manipal, India, with moderate and severe COVID-19 from 1 March to 1 August 2021. They were divided based on empirical therapy, and predictors of antibiotic usage were assessed by logistic regression. Four hundred and eighty (91.4%) COVID-19 patients received at least one course of antibiotics, with 440 (83.8%) initiating empirical therapy. Patients with severe COVID-19 manifestations were more likely to be prescribed empirical antibiotics. Multivariable analysis showed that patients initiated on empirical antibiotics had significantly elevated levels of procalcitonin [OR: 3.91 (95% CI: 1.66–9.16) (p = 0.001)], invasive ventilation [OR: 3.93 (95% CI: 1.70–9.09) (p = 0.001)], shortness of breath [OR: 2.25 (95% CI: 1.30–3.89) (p = 0.003)] and higher CRP levels [OR: 1.01 (95% CI: 1.00–1.01) (p = 0.005)]. Most antibiotics (65.9%) were prescribed from the ‘Watch’ group, the highest being ceftriaxone. Only 23.8% of the patients had microbiologically confirmed infections. The study identified predictors for initiating empirical antibacterial therapy in our setting.</p