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   Table of Contents     
LETTER TO EDITOR  
Year : 2014  |  Volume : 6  |  Issue : 1  |  Page : 42-43
Pattern of antibiotics prescription in a referral academic hospital, Northeast of Iran


1 Golestan Research Center of Gastroenterology and Hepatology; Golestan University of Medical Sciences, Gorgan, Iran
2 Golestan University of Medical Sciences, Gorgan, Iran
3 Golestan Research Center of Gastroenterology and Hepatology; Golestan University of Medical Sciences, Gorgan; Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran

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Date of Web Publication27-Feb-2014
 

How to cite this article:
Khodabakhshi B, Moradi A, Bijani E, Mansouri S, Besharat S, Besharat M. Pattern of antibiotics prescription in a referral academic hospital, Northeast of Iran. J Global Infect Dis 2014;6:42-3

How to cite this URL:
Khodabakhshi B, Moradi A, Bijani E, Mansouri S, Besharat S, Besharat M. Pattern of antibiotics prescription in a referral academic hospital, Northeast of Iran. J Global Infect Dis [serial online] 2014 [cited 2019 Aug 25];6:42-3. Available from: http://www.jgid.org/text.asp?2014/6/1/42/127953


Sir,

Irrational prescription of drugs could result in health and economic consequences which is evitable. [1],[2],[3] In many countries, antibiotics are about 30%-50% of prescribed drugs. [1],[4]

Increased resistant species and decreased efficiency of antibiotics cause enormous costs in health systems. [2],[3],[4]

A valid index called Anatomical Therapeutic Chemical-Defined Daily Dose (ATC/DDD) is defined by the World Health Organization (WHO) to study the drugs statistically. [2]

This study was conducted in 2009 in internal, infectious disease, and surgical wards and intensive care unit (ICU) of 5 th Azar Hospital affiliated to Golestan University of Medical Sciences. We studied 318 admitted patients who were randomly selected. Data gathered from patients' medical records. DDD/100 indicates the DDD of antibiotics per 100 occupied beds and is calculated as following [2] :



Among all recruited patients, 69% (220 cases) had received antibiotics. Total bed days occupation was 1791. DDD/100 bed days (also known as DBD) was 122.05 in which 76.84% were prescribed in intravenous forms.

Highest antibiotics prescription was seen in infectious diseases ward (259.62). Among 23 different prescribed antibiotics, the most (90.2%) were as following: Ceftriaxon (30%), clindamycin (21%), cephazolin (12%), metronidazole (9%), gentamycin (8.3%), azithromysin (8%), and ciprofloxacin (4%).

In 20% of patients (55% of prescription in surgery ward), the antibiotics were used in case of prophylaxis for bacterial infection in clean or clean-contaminated surgery procedures; in 87% of these cases, antibiotics were used more than 24 h. In 26 cases, no certain reason was found for antibiotic orders.

Despite the efforts of different organizations and researchers to reduce the indiscriminate use of antibiotics in hospitals, unfortunately, this trend is still continuing.

In a study in five Children's Hospital, China (2002-2006); all antibiotics' usage was reported 68.2, 58.4, 65.6, 65.8, and 49.9 DDD/100 bed days which the third generation of cephalosporin's was the most prevalent. In 2002, the usage was two times more than others and this trend was decreasing during years. [5]

In a similar study by Ebrahimzadeh et al., [2] in city of Sari, North of Iran the use of antibiotics increased from 95.4 DBDs in 2000 to 124 DBDs in 2005. Highest increase was seen in vancomycin (28.4 folds) and clindamycin (4.8 fold). Oncology ward, ICU, and general surgery consumed the most antibacterial agents in year 2000 and it changed to ICU ward, gynecology, oncology, and orthopedic in 2005. Cefazolin, ampicillin, ceftizoxime, and gentamicin were the most highly used antibiotics in 2000 and in year 2005, Cefazolin, ceftriaoxone, gentamicin, and ciprofloxacin were the most prescribed antibiotics. Intravenous antibiotics accounted for 51.8 and 79.4% of total DBDs in first half of years 2000 and 2005, respectively. [2]

More programmed efforts should be designed to decline the irrational and inappropriate usage of antibiotics, especially in academic hospitals.

Continuous medical education programs for physicians and nurses are among the programs with highest importance.


   Acknowledgment Top


Authors tend to appreciate the kind helpful hands of all personnel in different wards of 5 th Azar hospital. This paper was extracted from the doctorate thesis designed to fulfill the doctorate degree in Golestan University of Medical Sciences.

 
   References Top

1.Adebayo ET, Hussain NA. Pattern of prescription drug use in Nigerian army hospitals. Ann Afr Med 2010;9:152-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Ebrahimzadeh MA, Shokrzadeh M, Ramezani A. Utilization pattern of antibiotics in different wards of specialized Sari Emam University Hospital in Iran. Pak J Biol Sci 2008;11:275-9.  Back to cited text no. 2
    
3.Hutchinson JM, Patrick DM, Marra F, Ng H, Bowie WR, Heule L, et al. Measurement of antibiotic consumption: A practical guide to the use of the Anatomical Therapeutic Chemical classification and defined daily dose system methodology in Canada. Can J Infect Dis 2004;15:29-35.  Back to cited text no. 3
    
4.Miyawaki K, Miwa Y, Tomono K, Kurokawa N. Impact of antimicrobial stewardship by infection control team in a Japanese teaching hospital. Yakugaku Zasshi 2010;130:1105-11.  Back to cited text no. 4
    
5.Zhang W, Shen X, Wang Y, Chen Y, Huang M, Zeng Q, et al. Antibiotic use in five children's hospitals during 2002-2006: The impact of antibiotic guidelines issued by the Chinese Ministry of Health. Pharmacoepidemiol Drug Saf 2008;17:306-11.  Back to cited text no. 5
    

Top
Correspondence Address:
Sima Besharat
Golestan Research Center of Gastroenterology and Hepatology; Golestan University of Medical Sciences, Gorgan; Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.127953

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
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