Utilization pattern of antibiotics and drug related problems in the orthopedic department at a tertiary care hospital: a prospective study

Abstract

Background: Antibiotics are generally prescribed for both prophylactically and to treat ongoing infections in the orthopedic department. Assessment of prescribing pattern at regular interval is essential to avoid inappropriate use of drugs. Objectives: To know the utilization pattern of antibiotics and drug related problems like adverse drug reactions (ADR) and drug-drug interactions (DDI) in hospitalized patients. Materials and Methods: A cross-sectional study was conducted among hospitalized patients using WHO Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology for one month duration in orthopedic department at a tertiary hospital. Standard data collection forms were used to collect the data. Descriptive statistics were used for analyzing the data. Results: Out of 196, most of patients (72.96%) were male and most of patients (34.69%) were from the age group 21-30 years. A total of 782 drugs were prescribed during study period and among them 262 were antibiotics. None of the drugs were prescribed in generic name. Ceftriaxone (33.58%) was the most frequently prescribed antibiotic. Average cost of drug therapy per patient was NPR 3125.7. DDD/100 bed-days were highest for Cefixime (27.9).  A total of 233 ADRs were suspected in 64 patients (32.6%). Thrombophlebitis (26.2%) was the commonest ADR. Potential DDI were found in 51 patients (26.02%). The most common interacting pairs were Cefuroxime and Rabeprazole (15 encounters). Conclusion: Generic prescribing is urgently needed for cost minimization. The prevalence rate of ADR occurrence and DDI was high. The study finding benefits the hospital policy makers to formulate and address policies for rational use of antibiotics. Keywords: Adverse Drug Reactions; Antibiotics; Cost; Drug Utilization; Drug-Drug interaction