Abstract

Farhan Ahmad Khan *, Sheikh Nizamuddin Mohammad Tariq Salman

This study was carried out to study the pattern of antimicrobial prescription in OPD and IPD of the department 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 ENT OPD and IPD were included. Out of 4800 patients, only 2600 patients were included in the study, 60% (n=1560) were males and 40% (n=1040) were females. Maximum no. of patients were in the age group 16-35 years 60% (n=1560) while the geriatric group (76-85 years) comprised the lowest 1.9% (n=50). 55% (n=1430) of patients were diagnosed with ear, 30% (n=764) with throat and 15% (n=296) with nose disorders. 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%). Further, 69.11% of the patients received single antibacterial drug and the average number of antibacterial agents prescribed per patient per course was found to be 1.38. It was also observed that 75.43% of the antibacterials were prescribed by oral route. 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 & 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 was the most common concomitant drug used. The cost of treatment in IPD patients were 4.11 times more than the OPD patients.