Abstract
Background: Upper respiratory tract infection (URI) represents the most common acute illness evaluated in the outpatient setting. URIs range from the common cold—typically a mild, self-limited, catarrhal syndrome of the nasopharynx—to life-threatening illnesses such as epiglottitis. Antimicrobials are the mainstay in the management and irrational use of them may increase resistance to bacteria and the total cost of treatment.
Objectives: To evaluate the pattern of drug prescriptions for respiratory tract infections in Medicine and Pediatric outpatient departments of a rural teaching hospital.
Methods & Patients: Over a period of 18 months, 391 prescriptions of outpatients with respiratory tract infection were collected. The drugs prescribed, their dose and duration of treatment were recorded. DU 90% was calculated.
Results: Data from a total of 603 medical case records pertaining to respiratory tract infective disorders were assessed. The mean (±SEM) age of the patients was38.55±0.9 years and there were 204 (52.1%) men and 187 (42.1%) women. The most common disorder among the patients was acute rhinitis (61.1%) while the least common was acute bronchitis (1.3%). The prevalence of RTIs was slightly higher in males. The preferential AMAs employed were amoxicillin, amoxicillin-clavulinic acid combination, ceftriaxone, cefixime and azithromycin used individually. Of 12 different AMAs prescribed in this study, 6 drugs (penicillin, cephalosporin, aminoglycosodes, ATT, macrolides and fluroquinolones) falls within DU90% segment. Bronchodilators and expectorants, mucolytics, cough suppressant, decongestants combination is noteworthy. The concurrent use of different groups of bronchodilators along with inhalational corticosteroids is also highlighted. Ranitidine, omeprazole and pantoprazole were the foremost gastroprotective agents. A variety of heterogenous adjuvants other than those mentioned above were administered and their roles in conferring additional therapeutic benefits have been emphasized. Majority of drugs used are from NLEM 2011.
Conclusion: Penicillins and cephalosporins were the commonly used antibiotics for respiratory tract infection in outpatients of a rural teaching hospital and two thirds of the prescribed drugs were essential medicines. The overall impression about the prescription trends noted herein is suggestive of modest and rational approach in prescribing practices.
Keywords: Respiratory tract infections, Drug utilization, Antimicrobial agents.
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Corresponding Author
Dr Dipankar Bhattacharyya
Associate Professor, Department of Physiology,
Jagannath Gupta Institute of Medical Sciences And Hospital,
Budge Budge, West Bengal 700137, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.16
