Abstract

The objective of this research is to study the pattern of antimicrobial prescription in outpatient (OPD) and inpatient (IPD) of the Department of Otolaryngology in a tertiary care teaching hospital of North India. This was a prospective study conducted at the Teerthanker Mahaveer Medical College and Research Centre, over a period of 12 months. All the patients who attended the Ear Nose and Throat (ENT) OPD and IPD were included. The results show that out of 4800 patients, only 54% (n=2600) of patients were included in the study on the basis of inclusion and exclusion criteria and 31.25 % (n=1500) were defaulters. Majority of the patients were male 60% (n = 1560). Majority of the patients had suffered from ear disorders, 55% (n=1430). The most frequently prescribed antibacterials were β-Lactams (75.68%) followed by aminoglycosides (9.43%). Among the penicillin group, the commonest drug prescribed was a combination of amoxicillin and clavulanic acid (9.58%), in cephalosporins was cefixime (37.98%) and in aminoglycosides was gentamicin (6.25%). In the concomitant medications antihistaminic were prescribed in 11.53%, proton pump inhibitors in 20.38% cases and NSAIDS in 7.26% cases. The average number of drugs used in each prescription was 2.70. All the drugs were prescribed with trade names. The average cost per prescription per day in OPD and IPD patients were Rs.45 and Rs.185, respectively. Out of 2600 patients; culture sensitivity tests were performed for only 71 patients (inclusive of OPD and IPD). Of which only 43 patients depicted a positive culture sensitivity tests. Our study showed that antimicrobials were mostly prescribed in patients of ear diseases while it was least in throat disorders. Proton pump inhibitors were the most common concomitant drug used. The cost of treatment in IPD patients were 4.11 times more than the OPD patients.

Key words: Antibacterial agents, drug utilization, ear nose and throat (ENT) infections, prescribing pattern, pharmacoepidemiology.