Download presentation
Presentation is loading. Please wait.
Published byRoderick Reed Modified over 8 years ago
1
SURVEILLANCE OF ANTIMICROBIAL USE AT ALL LEVELS OF THE HEALTH SECTOR: AN INTERVENTION IN ITSELF? Thatte UM, Kulkarni RA, Holloway K, Sorenson T, Koppikar GV, Shinkre N, Chaudhury RR TNMC & BYL Nair Charitable Hospital, Mumbai 400 008
2
Background Antimicrobial resistance: a global problem Irrational prescribing of antibiotics and lack of adequate patient knowledge contributes to this problem
3
Objective To determine and compare, in a specified area of Mumbai, the antimicrobial usage patterns at different levels of the health care system. Study Design : Prospective, time series study over one year
4
E-ward 4.5 lakh population 1 tertiary care hospital 12 municipal dispensaries (MD) 120 Private practitioners (GP) 75 Chemists
5
Study setting Institutional Ethics Committee permission Medicine and Pediatric Out Patient Departments (OPD) of tertiary hospital 9 Municipal dispensaries (MD) 90 Private Practitioners (GPs) 65 Chemist shops (Ch) Data collection: Exit interviews Prescription audit 300 patients & prescriptions per month
6
Outcome measures Average number of drugs prescribed per patient % patients prescribed antimicrobials % patients prescribed multiple antimicrobials % patients prescribed antimicrobials in underdosage % patients treated in accordance with clinical guidelines % patients who know their dosing regimens
7
Percentage antibiotics of total drugs prescribed 25-30% were antibiotics 3-4 drugs prescribed per patient, of which 25-30% were antibiotics Commonly prescribed antibiotics OPD & MD: Cotrimoxazole & Amoxycillin GP & Chemists: Quinolones & Cephalexin 5-25% patients prescribed multiple antibiotics including combinations; more commonly at GPs & chemists
8
% Antibiotics dispensed from the facility Dispensing GPs!!! % antibiotics prescribed as Generics OPD & MD: 30 – 40% GPs : 40-60%
9
% patients prescribed antibiotics in under-dosage Less than 10% patients prescribed antibiotics correctly as per clinical guidelines, except at OPDs
10
Chemist shops Less than 5% patients given correct and complete information regarding antibiotics dispensed by chemist Less than 2% patients dispensed antibiotics without prescriptions at Chemist shops: Intervention due to the presence of field officers??
11
% patients with adequate knowledge of the dosing schedule of the prescribed drugs Good knowledge w.r.t dosing schedule: Intervention due to the presence of field officers??
12
% patients with knowledge that antibiotic has been prescribed Inadequate knowledge!!! % patients with knowledge that incomplete Rx can cause resistance
13
Conclusion Antibiotic prescribing rampant at all levels of health care, especially in the private sector Patient knowledge woefully inadequate: Less than 10% patients prescribed antibiotics as per clinical guidelines Less than 5% aware that an antibiotic has been prescribed and that incomplete therapy can cause drug resistance Inadvertent interventions: Decrease in number of antibiotics dispensed without prescriptions at chemists Improved patient information w.r.t dosage schedule
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.