Prescribing patterns and utilization of antimicrobial drugs in a tertiary care teaching hospital of a Caribbean developing country.
Fundamental & clinical pharmacology
; 23(5): 609-615, Oct, 2009. tabgraf
Article
in English
| MedCarib
| ID: med-17867
Responsible library:
TT5
Localization: TT5; W1, FU538TS
ABSTRACT
This study aimed to evaluate the prescribing practices and utilization of antimicrobials in a tertiary care teaching hospital of a Caribbean developing country. A prospective observational cohort study was undertaken for a period of 12 weeks in the general wards and the intensive care unit (ICU) of the hospital. Demographic data, diagnoses on admission, antimicrobials prescribed, dosage and duration, route of administration, leukocyte count and microbiological culture and sensitivity reports were recorded. Hospital length of stay and final outcome were recorded. The usage was determined in terms of prescribed daily dose and the total costs of antimicrobials were calculated. Of 889 patients admitted, 335 (37.7 percent) received 22 different antimicrobial drugs. Overall, 67 percent of the prescriptions adhered to the hospital protocol. Median length of stay in the hospital was 7 days. Skin and soft tissue infections were the most common diagnoses for which antimicrobials were prescribed. Amoxicillin-clavulanate was the most common (32 percent) antimicrobial used. Eighty-nine percent of the antimicrobials were given through the intravenous route. Sixty percent of the patients received two antimicrobials, 26 percent received three, and 14 percent of patients were prescribed four or more antimicrobials during their stay at the hospital. There was significantly higher inappropriate choice of antimicrobials in ICU when compared with general wards (Mantel-Haenszel Odds Ratio 3.3; 95 percent Confidence Intervals 1.4, 7.7). Prescribing patterns did not strictly adhere to the hospital antimicrobial protocol. There is a need for monitoring and control of antimicrobial prescription.
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Collection:
International databases
Database:
MedCarib
Main subject:
Trinidad and Tobago
/
Developing Countries
/
Drug Utilization
Type of study:
Practice guideline
/
Observational study
Aspects:
Social determinants of health
Limits:
Humans
Country/Region as subject:
English Caribbean
/
Trinidad and Tobago
Language:
English
Journal:
Fundamental & clinical pharmacology
Year:
2009
Document type:
Article
Institution/Affiliation country:
The University of the West Indies/Trinidad and Tobago