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ABSTRACT
BACKGROUND: Irrational drug use has been a global problem over the time and has a serious repercussion on the patient and even the prescriber. With the discovery of many drugs especially antibiotics in the last century, many prescribers have had the tendency of either under or over prescribing these drugs to patients, a habit which may negatively affect the patient.
OBJECTIVES: The main aim of this study was to describe pattern of antibiotic prescription in the Buea Regional Hospital (BRH), over a one year period (June 2012 and June 2013).
METHODS: It was a cross-sectional and retrospective descriptive study using prescription sheets of both inpatients and outpatients. Data obtained were analysed using Epi Info statistical software.
RESULTS: There were 1,576 prescribed drugs from 425 prescriptions with at least an antibiotic, with the mean number of drug per prescription being 3.7±1.3drugs and a mode of 3 drugs per prescription (38.8%, 95% C.I). As much as 47.5% had more than 4 drugs per encounter. More so, 637 antibiotics were prescribed giving a proportion of antibiotics per encounter of 40.4% with a mean of 1.5±0.7drugs, and the most commonly prescribed antibiotics was ceftriaxone, 191(30.0%) and metronidazole, 119(18.7%). The cephalosporins (30.0%) and penicillins (25.8%) were the most common class of antibiotics. 43.8% of the antibiotics were prescribed by brand names and 50.1% were administered via parenteral routes. The mean duration of antibiotic therapy was 5.5±4.5days. The most frequent indications of antibiotic prescription were gastrointestinal tract infections (22.6%) and respiratory tract infections (15.3%). There were 14.6% of the prescriptions with no indication clearly written and 6.4% had no information relating to the prescriber.
CONCLUSION: Antibiotic prescription in the BRH was inappropriate with main reason being lack of clearly defined working diagnosis. Polypharmacy is a big problem in this health facility. Ceftriaxone was the most frequently prescribed antibiotic with gastrointestinal tract infection being the most indication.
KEYWORDS: prescription, antibiotics, rational drug use, polypharmacy.
RÉSUMÉ
CONTEXTE : L’usage irrationnel des médicaments est devenu un problème mondial au fil du temps et a de graves répercussions sur le patient et le prescripteur. Avec la découverte de nombreux médicaments particulièrement des antibiotiques au cours du siècle dernier, de nombreux prescripteurs ont une tendance soit vers la sous soit vers la sur prescription de ces médicaments, une habitude qui peut avoir des répercussions négatives sur le patient.
OBJECTIFS : L'objectif principal de cette étude était de décrire les habitudes de prescription des antibiotiques au sein de l'Hôpital Régional de Buea (BRH), sur une période d’un an (juin 2012 et juin 2013).
MÉTHODES : Il s'agit d'une étude transversale, rétrospective et descriptive basée sur l’exploitation des feuilles de prescription des patients hospitalisés et non hospitalisés. Les données obtenues ont été analysées en utilisant le logiciel Epi Info.
RÉSULTATS: Il y a eu 1 576 médicaments prescrits, et 425 ordonnances avaient au moins un antibiotique. Le nombre moyen de médicaments par ordonnance était 3,7 ± 1,3 et le mode était de 3 médicaments par ordonnance (38,8 %, 95% C. I).
47,5 % des ordonnances avaient plus de 4 médicaments par consultation. 637 antibiotiques ont été prescrits donnant une proportion d'antibiotiques par rencontre de 40,4 % avec une moyenne de 1,5 ± 0,7 antibiotiques, et les antibiotiques les plus couramment prescrits était la ceftriaxone, 191 ( 30,0 %) et le métronidazole, 119( 18,7 %). Les céphalosporines (30.0 %) et les pénicillines (25,8 %) ont été les classes d'antibiotiques les plus fréquentes. 43,8 % des antibiotiques étaient des médicaments de spécialités (marques) et 50,1 % ont été administrés par voie parentérale. La durée moyenne de l'antibiothérapie était de 5,5 ± 4,5 jours. Les indications plus fréquentes de prescription des antibiotiques étaient les infections du tractus gastro-intestinal (22,6 %) et les infections des voies respiratoires (15,3 %). Pour 14,6 % des prescriptions, aucune indication n’était clairement écrite et 6,4 % n'avaient aucune information concernant le prescripteur.
CONCLUSION: La prescription des antibiotiques est largement inappropriée à l’Hôpital Régional de Buéa et la raison principale est le manque de définition claire du diagnostic. La polymédication est un gros problème dans cet établissement de santé. La ceftriaxone est l’antibiotique le plus fréquemment prescrit, les infections du tractus gastro-intestinal étant l’indication la plus fréquente.
MOTS-CLÉS : Prescription, antibiotiques, utilisation rationnelle des médicaments, polymédication.
Keywords
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References
- Riaz H, Malik F, Raza A, Hameed A, Ahmed S, Shah S A, Hussain S. Assessment of Antibiotic Prescribing Behaviour of Consultants of Different Localities in Pakistan. Afr. J. Pharm. Pharmacol. Vol. 5(5), pp. 596-601, May 2011. Available online http://www.academicjournals.org/ajpp Accessed February 5th, 2012.
- Kathleen Holoway and Liset van Dijk. WHO (2011): The World Medicines Situation 2011. Rational Use of Medicines 3rd edition, Geneva 2011.
- Lifang Dong, Hong Yan and Duolao Wang, Antibiotic Prescribing Pattern in Village Health Clinics across 10 provinces of Western China. Journal of Antimicrobial chemotherapy (2008) 62, 410—415
- Akande, T.M. and M.o. Ologe, 2007. Prescription pattern in a secondary health facility in Ilorin, Nigeria. Annal. Afr. Med., 6(4): 186—189. NLM ID: 1012314417. http://www.biolone.org.br/abstract?id=am07041 &lang=en. Accessed February 5th, 2011.
- Tamuno I and Fadare J. Drug Prescription Pattern in a Nigerian Tertiary Hospital. Tropical Journal of Pharmaceutical Research February 2012; 11 (1): 146-152 Tamuno et al. 2012.
- Hiramatsu, K., Hanaki, H., Ino, T., et al. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J. Antimicrob. Chemother., 1997, 40:135-136.
- Akande TM, Ologe M, Medubi GF. Antibiotic prescription pattern and cost at University of Ilorin Teaching Hospital, Ilorin, Nigeria. International Journal of Tropical Medicine 2009; 4(2): 50-54.
- BUCREP. Rapport de presentation des resultants definitifs. Yaounde. BUCREP. 2010
- Getachew E, Aragaw S, Adissie W and Agalu A. Antibiotic prescribing pattern in a referral hospital in Ethiopia. African Journal of Pharmacy and Pharmacology Vol. 7(38), pp. 2657-2661, 15 October, 2013
- Feghali R, Adib SM (2011). Compliance with good practice in prescription writing at our patient clinics in Saudi Arabia. East Meditrr. 17(8):722-744
- Aikhasci-alnasia TM, Seguarie RP (2005). An evaluation of prescribing error in Bahrain PHC service. Int. J. Eli Pharmacol. 46(6):194-210.
- Osama HMI. Evaluation of drug and antibiotic utilization in an Egyptian university hospital: an interventional study. Intern Med. 2012;2(2):1-3.
- Isah AO, Laing R, Quick J, Mabadeje AFB, Santoso B, Hogerzeil H, Ross-Degnan D. The Development of Reference Values For the World Health Organization (WHO) Health Facility Core Prescribing Indicators. West Afr. J. Pharmacol. Drug. Res. 2002; 18(1 & 2): 6–11.
- Abu-Saeed K, Gbenga S and Folake L. Prescription Pattern of Antibiotics among Physicians in a Secondary Health Facility in Abuja, Nigeria. British Journal of Pharmaceutical Research 3(4): 940-947, 2013.
- Abdulkareem M. Al-Shami, Mohamed Izham M.I., Ahmed Abdo-Rabbo Evaluation of the Quality of Prescriptions with Antibiotics in the Government Hospitals of Yemen, Yemen. Journal of Clinical and Diagnostic Research. 2011 August, Vol-5(4): 808-812
- Desta Z, Abula T, Asfawosen G (2002). Prescription pattern in three hospitals in Northwest Ethiopia. EJHD. 16(2):183-189.
- WHO. Promoting Rational Use of Medicines Saves Lives and Money. WHO Experts Say. http://www.who.int 2004; 10: 406–415 (Press Release 29-3-2004)- Accessed March 1 2014.
- Chareonkul C, Khun VI, Boonshuyar C. Rational Drug Use in Cambodia: Study of Three Pilot Health Centers in Kampong horn Province.South-East Asian J. Trop. Med. Public Health. 2002; 33: 418–424.
References
Riaz H, Malik F, Raza A, Hameed A, Ahmed S, Shah S A, Hussain S. Assessment of Antibiotic Prescribing Behaviour of Consultants of Different Localities in Pakistan. Afr. J. Pharm. Pharmacol. Vol. 5(5), pp. 596-601, May 2011. Available online http://www.academicjournals.org/ajpp Accessed February 5th, 2012.
Kathleen Holoway and Liset van Dijk. WHO (2011): The World Medicines Situation 2011. Rational Use of Medicines 3rd edition, Geneva 2011.
Lifang Dong, Hong Yan and Duolao Wang, Antibiotic Prescribing Pattern in Village Health Clinics across 10 provinces of Western China. Journal of Antimicrobial chemotherapy (2008) 62, 410—415
Akande, T.M. and M.o. Ologe, 2007. Prescription pattern in a secondary health facility in Ilorin, Nigeria. Annal. Afr. Med., 6(4): 186—189. NLM ID: 1012314417. http://www.biolone.org.br/abstract?id=am07041 &lang=en. Accessed February 5th, 2011.
Tamuno I and Fadare J. Drug Prescription Pattern in a Nigerian Tertiary Hospital. Tropical Journal of Pharmaceutical Research February 2012; 11 (1): 146-152 Tamuno et al. 2012.
Hiramatsu, K., Hanaki, H., Ino, T., et al. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J. Antimicrob. Chemother., 1997, 40:135-136.
Akande TM, Ologe M, Medubi GF. Antibiotic prescription pattern and cost at University of Ilorin Teaching Hospital, Ilorin, Nigeria. International Journal of Tropical Medicine 2009; 4(2): 50-54.
BUCREP. Rapport de presentation des resultants definitifs. Yaounde. BUCREP. 2010
Getachew E, Aragaw S, Adissie W and Agalu A. Antibiotic prescribing pattern in a referral hospital in Ethiopia. African Journal of Pharmacy and Pharmacology Vol. 7(38), pp. 2657-2661, 15 October, 2013
Feghali R, Adib SM (2011). Compliance with good practice in prescription writing at our patient clinics in Saudi Arabia. East Meditrr. 17(8):722-744
Aikhasci-alnasia TM, Seguarie RP (2005). An evaluation of prescribing error in Bahrain PHC service. Int. J. Eli Pharmacol. 46(6):194-210.
Osama HMI. Evaluation of drug and antibiotic utilization in an Egyptian university hospital: an interventional study. Intern Med. 2012;2(2):1-3.
Isah AO, Laing R, Quick J, Mabadeje AFB, Santoso B, Hogerzeil H, Ross-Degnan D. The Development of Reference Values For the World Health Organization (WHO) Health Facility Core Prescribing Indicators. West Afr. J. Pharmacol. Drug. Res. 2002; 18(1 & 2): 6–11.
Abu-Saeed K, Gbenga S and Folake L. Prescription Pattern of Antibiotics among Physicians in a Secondary Health Facility in Abuja, Nigeria. British Journal of Pharmaceutical Research 3(4): 940-947, 2013.
Abdulkareem M. Al-Shami, Mohamed Izham M.I., Ahmed Abdo-Rabbo Evaluation of the Quality of Prescriptions with Antibiotics in the Government Hospitals of Yemen, Yemen. Journal of Clinical and Diagnostic Research. 2011 August, Vol-5(4): 808-812
Desta Z, Abula T, Asfawosen G (2002). Prescription pattern in three hospitals in Northwest Ethiopia. EJHD. 16(2):183-189.
WHO. Promoting Rational Use of Medicines Saves Lives and Money. WHO Experts Say. http://www.who.int 2004; 10: 406–415 (Press Release 29-3-2004)- Accessed March 1 2014.
Chareonkul C, Khun VI, Boonshuyar C. Rational Drug Use in Cambodia: Study of Three Pilot Health Centers in Kampong horn Province.South-East Asian J. Trop. Med. Public Health. 2002; 33: 418–424.