Shankar P R, Upadhyay D K, Subish P, Dubey A K, Mishra P
Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal.
Singapore Med J. 2006 Apr;47(4):261-5.
Infants and children constitute a large proportion of the population in developing countries. In Nepal, studies on drug use patterns in the paediatric age group are lacking in hospitals in the western region. The present study was carried out to obtain demographical information and information on the prescribing patterns of drugs. The antibiotic sensitivity patterns of commonly-isolated micro-organisms and the mean cost of drugs were obtained.
The study was carried out over a four-month period (December 1, 2003 to March 31, 2004) at the Manipal Teaching Hospital, a tertiary care hospital in Pokhara, western Nepal. The case records of patients discharged from the paediatrics ward during the study period were analysed. Mean number of drugs prescribed was calculated. The percentage of admissions that were prescribed antibiotics was determined.
356 patients were admitted during the study period, of which 228 were male. The median duration of hospitalisation was four days. The mean number of drugs prescribed per admission was 4.5. 789 drugs (48.9 percent) were prescribed by the parenteral route. Antibiotics were prescribed in 249 admissions (69.9 percent). Staphylococcus aureus, Escherichia coli, and Acinetobacter species were the common organisms isolated, and were resistant in some cases to the commonly-used antibiotics. The mean (+/- standard deviation) cost of drugs per admission was 5.4 (+/-1.6) US dollars.
Prescribing by generic name should be encouraged. Use of parenteral antibiotics was high and route conversion programmes should be instituted. Use of antibiotics for predominantly viral infections should be reduced. Treatment guidelines for common conditions should be formulated.
婴幼儿在发展中国家人口中占很大比例。在尼泊尔,西部地区的医院缺乏关于儿科年龄组用药模式的研究。本研究旨在获取人口统计学信息以及药物处方模式的信息。同时还获取了常见分离微生物的抗生素敏感性模式和药物的平均成本。
本研究于2003年12月1日至2004年3月31日在尼泊尔西部博卡拉的三级护理医院马尼帕尔教学医院进行了为期四个月的研究。分析了研究期间儿科病房出院患者的病例记录。计算了平均处方药物数量。确定了使用抗生素的住院患者百分比。
研究期间共收治356例患者,其中男性228例。中位住院时间为4天。每次住院的平均处方药物数量为4.5种。789种药物(48.9%)通过肠外途径给药。249例住院患者(69.9%)使用了抗生素。金黄色葡萄球菌、大肠杆菌和不动杆菌属是常见的分离微生物,在某些情况下对常用抗生素耐药。每次住院的药物平均(±标准差)成本为5.4(±1.6)美元。
应鼓励使用通用名开药。肠外抗生素的使用比例较高,应制定途径转换方案。应减少主要用于病毒感染的抗生素的使用。应制定常见病症的治疗指南。