Assessment of Antibiotic Prescription Pattern Using who Prescribing Indicators and Aware Categorization of Antibiotics
Sidra Mushtaq, Fatima Javed, Mufakhara Fatimah, Zaeem Sohail Jafar, Syeda Tahira Zaidi, Asia Firdous, Ajaz Fatima
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ABSTRACT
Background: Medicines play a crucial role in the
healthcare delivery of a hospital. The appropriate use of medicines gives us
assessment of the quality of health services being provided in a particular
region.
Aim: To evaluate the prescribing practices and antibiotic
utilization patterns so that the extent of irrational use can be assessed by
comparing them with published ideal values set by WHO.
Study design: Retrospective, cross-sectional study.
Place and duration of study: Teaching Hospital of Faisalabad: Independent
University Hospital (IUH), from Jan 2018 to June/July 2018.
Methodology: 200 cases were
selected through systematic random sampling from medicine/surgery
wards and pharmacy registers. The standard
World Health Organization prescribing indicators and AWaRe categorization of
antibiotics were used to assess the prescribing practices of
physicians/surgeons. Published ideal standards for each of the indicators were
compared with study findings to identify extent of irrational drug use.
Results: Most of the
facility indicators were met with. The Drug and Therapeutic Committee (DTC) was
functional. The Standard treatment guideline booklets (STGs) and Essential
Drugs List (EDL) of the hospital were available. 88% of the key drugs listed in
EDL were available in stock. The expenditure on antibiotics compared to total
medicines was 17%. Regarding prescribing indicators:
the average number of drugs prescribed per encounter was 6 (optimal value
1.6–1.8). Average
no of antibiotic per prescription amounted to almost 1 (0.925). % prescriptions
with an antibiotic amounted to 72% (optimal value 20-26.8%).72% antibiotics
were prescribed from the EDL formulary of the hospital (optimal value 100%).
Conclusion: Regarding
compliance with prescribing indicators and AWaRe categorization of antibiotics
by WHO, significant deviation was observed. Education and training of
physicians according to WHO parameters is required to ensure rational
prescribing.
Keywords: Prescription
pattern, WHO Prescribing Indicators, AWaRe Categorization