Evaluation of antibiotic use in ED at a tertiary care hospital.

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Journal name: World Journal of Pharmaceutical Research
Original article title: Evaluation of antibiotics use at emergency department in a tertiary care hospital
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Pooja B. R., Dr. T. Vithya, Dr. Shankar Prasad and Jothi R.


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Evaluation of antibiotics use at emergency department in a tertiary care hospital

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr20232-26981

Copyright (license): WJPR: All rights reserved


Download the PDF file of the original publication


Summary of article contents:

Introduction

Emergency Departments (EDs) play a critical role in healthcare by catering to urgent medical and surgical needs. Given the high demands of these environments, antibiotic prescriptions are common, yet often inappropriate, leading to adverse effects and the growing problem of antimicrobial resistance (AMR). This study focuses on evaluating the pattern of antibiotic usage in the emergency department at St. Philomena's Hospital in Bangalore, aiming to understand the common practices and implications for patient care.

Prescribing Trends in Antibiotics

The study revealed that out of 329 patients who received antibiotic prescriptions, the predominant demographic was female, accounting for 51.9%, with the most frequent complaint being fever with myalgia (14.2%). Azithromycin emerged as the most prescribed antibiotic for this condition, with 39.51% of patients receiving it. Other notable antibiotics included ciprofloxacin and tinidazole (15.50%) and amoxicillin combined with clavulanic acid (11.55%). This highlights a trend towards using macrolides in common febrile illnesses in the emergency setting.

Adherence to Guidelines

An important finding of the study is that 97.06% of antibiotic prescriptions adhered to the hospital's standard prescribing guidelines. Only 2.12% of prescriptions did not conform to these guidelines, representing a small fraction of the antibiotic prescriptions. This suggests that the prescribing practices in the ED are largely rational and aligned with established protocols, which is critical for effective patient management and antimicrobial stewardship.

Adverse Drug Reactions

Despite the general adherence to guidelines, the study documented two instances of adverse drug reactions (ADRs) among the patients. One patient experienced itching after receiving injectable ciprofloxacin, and another developed rashes from metronidazole. Both adverse reactions were characterized as "probable" according to the WHO and Naranjo causality assessment scale. This underlines the necessity for monitoring and managing potential ADRs even in well-regulated prescribing environments.

Conclusion

The findings of this study indicate that antibiotic prescribing patterns in the emergency department of St. Philomena's Hospital are primarily rational, with a strong adherence to clinical guidelines. The presence of a clinical pharmacist could further enhance the optimization of antibiotic choices by ensuring thorough patient medical histories are collected, thereby minimizing risks of inappropriate prescribing and ADRs. Continuous monitoring of these practices is essential to combat antibiotic resistance and ensure the safety and effectiveness of patient care in emergency situations.

FAQ section (important questions/answers):

What was the aim of the study conducted at the emergency department?

The study aimed to evaluate the pattern of antibiotic prescribing in the emergency department of St. Philomena's Hospital over a nine-month period, assessing the appropriateness of the selected antibiotics in various cases.

Which antibiotic was most commonly prescribed for fever with myalgia?

The most commonly prescribed antibiotic for patients presenting with fever and myalgia was Azithromycin.

How many patients were included in the study conducted at the ED?

A total of 329 patients who received antibiotics were included in the study, with a majority being females.

What percentage of antibiotic prescriptions followed the hospital's standard guidelines?

Approximately 97.06% of the antibiotic prescriptions (322 out of 329) adhered to the standard prescribing guidelines of the hospital.

What types of adverse reactions were reported during the study?

Two patients experienced adverse drug reactions; one had itching from ciprofloxacin, and another developed rashes from metronidazole during the study.

How can clinical pharmacists improve antibiotic prescribing in emergency departments?

The presence of clinical pharmacists can enhance patient care by collecting medical histories and medication information, assisting physicians in making appropriate antibiotic choices.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Evaluation of antibiotic use in ED at a tertiary care hospital.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Antibiotic (Antibacterial):
The term antibiotics refers to a broad class of drugs used to combat bacterial infections. These medications are among the most prescribed in emergency settings, reflecting their critical role in managing conditions like respiratory and urinary tract infections, thereby helping to reduce hospital admissions and complications.

2) Study (Studying):
The study specifically outlines a hospital-based observational research conducted over nine months at St. Philomena’s Hospital. It analyzes antibiotic prescription patterns in the emergency department, aiming to evaluate adherence to guidelines, identify common medications prescribed, and observe any adverse drug reactions among patients treated with antibiotics.

3) Fever:
Fever is a common symptom indicating infection or illness, often leading patients to seek care in emergency departments. In the study, fever with myalgia was identified as a frequent complaint among patients, thus influencing antibiotic prescribing choices made by healthcare professionals.

4) Pooja:
Pooja B. R. is the first author of the study, responsible for conducting the research and compiling the observations regarding antibiotic prescriptions. Her academic affiliation with Al-Ameen College of Pharmacy highlights the contribution of pharmacy students in research that can improve clinical practices in hospital settings.

5) Drug:
The term drugs encompasses a wide range of substances used for medical treatment, including antibiotics. In the context of the study, evaluating the drugs prescribed in the emergency department is crucial for understanding treatment effectiveness and adherence to clinical guidelines.

6) Table:
Tables in the study present organized data summarizing findings related to antibiotic prescriptions, such as classes of antibiotics used and the demographics of patients treated. These visual aids are essential for effectively communicating research results, trends, and statistical analyses to readers and other healthcare professionals.

7) Pain:
Pain is often a symptom that leads patients to the emergency department, triggering the need for evaluation and potential treatment with antibiotics. The study identifies abdominal pain as one of the common complaints; therefore, understanding pain management is crucial in emergency care settings.

8) Vomiting:
Vomiting can be a symptom associated with various illnesses, including infections requiring antibiotic treatment. In the study, several patients presented with complaints of vomiting, highlighting the importance of addressing gastrointestinal symptoms and ensuring effective antibiotic therapy when managing such cases.

9) Itching:
Itching is a possible adverse drug reaction that can occur after administering certain medications, including antibiotics. The study reported cases where patients experienced itching after receiving antibiotics, underscoring the importance of monitoring for side effects to ensure patient safety and appropriate drug management.

10) Beta:
Beta refers to a classification under which certain antibiotics fall, specifically beta-lactam antibiotics that interfere with bacterial cell wall synthesis. Understanding these classifications helps healthcare professionals to select appropriate antibiotics based on the type of infection and its causative agents.

11) Collecting:
Collecting in this context refers to the process of gathering patient data and medication histories during the study. This practice is essential in ensuring accurate assessment and monitoring of antibiotic use, ultimately aiding in making informed clinical decisions for effective patient care.

12) Burning (Burn, Burned, Burnt):
Burn refers to tissue injury that may necessitate medical intervention. While burns often require pain management and wound care, the potential for infections in burn sites implies a need for careful consideration of antibiotic therapy in emergency departments.

13) Male:
Male refers to one of the genders included in the study's population. The demographic data collected allows for an understanding of antibiotic prescribing trends and patient outcomes, emphasizing the need for a diverse analysis of treatment effectiveness across different groups.

14) Discussion:
Discussion in research typically involves the interpretation of study results, comparison with existing literature, and implications for clinical practice. The discussion emphasizes the findings related to antibiotic prescriptions within the emergency department, emphasizing the need for continuous evaluation of prescribing patterns.

15) Bleeding:
Bleeding can be a serious emergency condition often requiring immediate medical intervention. While not specifically mentioned in the study, any potential association of bleeding with infections may necessitate antibiotic treatment to prevent complications, demonstrating the critical role of antibiotics in emergency care.

16) Pregnant:
Pregnant women require careful consideration when prescribing antibiotics due to potencies and safety concerns for both the mother and fetus. The study highlights the importance of evaluating the prescribing patterns, particularly in vulnerable populations like pregnant women, to ensure proper healthcare delivery.

17) Quality:
Quality in healthcare signifies the standard of care delivered to patients. The study aims to evaluate the quality of antibiotic prescribing in the emergency department, ensuring that clinicians adhere to guidelines to minimize adverse effects and enhance treatment outcomes for patients.

18) Overuse:
Overuse of antibiotics is a critical concern leading to antimicrobial resistance. The study addresses the patterns of antibiotic prescriptions to prevent overuse, encouraging rational use of these medications to maintain their efficacy and limit the emergence of resistant bacterial strains.

19) Killing (Killed):
Killing refers to the primary function of antibiotics, which is to eliminate or inhibit the growth of bacteria. Understanding this process is essential in emergency settings, where timely antibiotic therapy can save lives and prevent the spread of infectious diseases.

20) Allergy:
Allergy is an adverse drug reaction that can occur with antibiotic use, ranging from mild reactions to severe anaphylaxis. The study's documentation of allergy symptoms emphasizes the need for careful monitoring and patient education regarding potential side effects of prescribed antibiotics.

21) Nausea:
Nausea is a common side effect associated with antibiotic use, which can influence patient adherence to prescribed therapies. The study's focus on adverse drug reactions draws attention to the importance of managing and communicating potential side effects to enhance treatment acceptance.

22) Edema (Oedema):
Oedema, or swelling, can occur as a reaction to certain medications, including antibiotics. Monitoring for oedema as an adverse effect underscores the importance of patient education and vigilance in recognizing any potentially harmful reactions during antibiotic treatment.

23) Visit:
A visit refers to a patient's presence in the emergency department seeking medical care, often leading to antibiotic prescriptions. The analysis of patient visits helps determine the patterns of prescribing and the primary conditions prompting such interventions.

24) Blood:
Blood analysis is a common diagnostic tool in emergency settings to identify infections that may necessitate antibiotic use. Understanding blood-related complaints and infection markers can guide healthcare professionals in appropriate antibiotic selection for effective patient care.

25) Joti:
Jothi R. is an author affiliation contributing to the study's design and implementation. Recognizing contributions from individuals with expertise in the field enhances the credibility of the research, providing insights into antibiotic prescribing practices in the emergency department.

26) Ras (Rash):
Rash is a potential adverse effect associated with antibiotic use, indicating an allergic or intolerant reaction in some patients. The study noted instances of rash occurrence after antibiotic administration, highlighting the need for careful monitoring and follow-up of patients post-treatment.

27) Wall:
Wall refers to the bacterial cell wall, which is a common target for many antibiotics. Understanding how antibiotics disrupt the integrity of bacterial walls is crucial for clinicians when prescribing effective treatments for infections in the emergency department.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Evaluation of antibiotic use in ED at a tertiary care hospital.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Research findings, Informed consent, Inclusion criteria, Clinical trial, Adverse drug reaction, Observational study, Antimicrobial Resistance, Hospital based prospective observational study, Surgical emergencies, Medical emergencies, Hospital care, Clinical pharmacist, Emergency Department, Antimicrobial resistance (AMR), Population demographics, Patient's medical history, Data source.

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