Evaluation of antimicrobial agents prescribed by universiti sains malaysia panel of doctors: a pharmacoepidemiology approach
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Date
2003
Authors
Ali Sawesi, Suhila
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Abstract
Drug utilization study is important in establishing the status of drug use
in a particular country, irrational prescribing is a global phenomenon. Many studies
have been carried out to document antibiotic use patterns, and indicate that over
I prescribing, multiple drug prescribing, misuse of drugs, use of unnecessary expensive ,, ...., drugs and overuse of antibiotics are the most common problems of irrational drug use
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by prescribers.
By retrospectively recording data from 2,013 claim forms issued to
students of Universiti Sains Malaysia during the period 1997, the study sets out to
examine different aspects of prescribing antibiotics to students. The claim forms were
selected non-randomly from the National Poison Center.
Results showed that the most frequent diagnosis given to USM's students
were upper respiratory tract infection (59.9%), acute gastroenteritis (5.8%) and urinary
tract infection (4.8%). Amoxycillin was the most common antibiotic given in cases of
upper respiratory tract infections (65.5%) and urinary tract infections (52%), while
Bactrim was the most common antibiotic given in cases of acute gastroenteritis (57.2%).
The total numbers of brand name antibiotics prescribed were 48.1 %. About 11.7% of
the claim forms did not follow the WHO Essential .Drug List and 19.6% of the antibiotic
claim form did not follow the Malaysian Standard Treatment Guidelines. Of the total
claim forms, 93% had unwritten dose, 59.8% had unwritten dosage form, 72.9% had
unwritten frequency and 77.7% had unwritten duration. It was found that 1.4% of
antibiotics were contraindication, 0.1% of antibiotic duplicated and 5.6% having drugdrug
interactions.
It was concluded in this study that current usage patterns of antibiotics in
USM's panel clinic indicate some potential problems due to inadequate monitoring for
drug interactions, a need to document outcome, some doctors not following the
r.r'' Malaysia Standard Treatment Guideline and drug formularies. Guideline should be
readily accessible to improve rational drug use. The average number of drugs per claim
,.~ forms, the percentage of claim forms with antibiotics prescribed and the percentage of
generic antibiotics prescribed, are the three areas, which need further intervention to
-improve the quality of health care.
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Keywords
Antimicrobial , Pharmacoepidemiology approach