WHO/INRUD prescribing indicators and prescribing trends of antibiotics in the Accident and Emergency Department of Bahawal Victoria Hospital, Pakistan
WHO/INRUD prescribing indicators and prescribing trends of antibiotics in the Accident and Emergency Department of Bahawal Victoria Hospital, Pakistan
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DOI：
10.1186/s40064-016-3615-1
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发表时间：
2016-11-08
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影响因子：
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通讯作者：
Scahill, Shane
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作者：
Atif, Muhammad;Azeem, Muhammad;Scahill, Shane
进行了一项描述性、回顾性和横断面研究，以评估巴基斯坦巴哈瓦尔布尔巴哈瓦尔维多利亚医院急诊科的处方做法和抗生素使用模式。从2014年1月1日至12月31日期间开出的1,080,000张处方中抽取4320张处方（系统随机抽样）。标准的世界卫生组织/国际合理使用药物网络处方指标被用来确定医生的处方做法。采用已公布的各项指标的理想标准来识别不合理用药。我们还使用了一个额外的指标来报告抗生素处方的百分比份额。每次就诊的平均处方药物数为2.3 (SD = 1.3)（最优值为1.6 ~ 1.8）。以通用名开具处方的发生率为83.1%（最优值100%）。处方抗生素和注射剂的比例分别为52.4%（20.0 ~ 26.8%）和98.0%（13.4 ~ 24.1%）。从基本药物清单开出的药物占81.5%（最优值100%）。在52.4% （n = 2262）处方中，77.7% （n = 1758）使用一种抗生素，22.1% （n = 499）使用两种抗生素，0.2% （n = 5）使用三种抗生素。头孢菌素是最常用的抗生素（81.5%），其次是青霉素类（6.4%）和氟喹诺酮类（6.2%）。单个抗生素中，头孢曲松占比最高，为71.8%，其次是头孢噻肟（5.6%）和甲硝唑（4.7%）。最常用的抗生素组合是环丙沙星与甲硝唑（52.1%）。不合理的处方做法很常见。医生需要继续接受教育和培训，以确保今后在Bahawal Victoria医院合理开处方。
A descriptive, retrospective and cross sectional study was conducted to assess the prescribing practices and antibiotic use patterns in the Accident and Emergency department of the Bahawal Victoria Hospital, Bahawalpur, Pakistan. A sample of 4320 prescriptions (systematic random sampling) was drawn out of a total of 1,080,000 prescriptions written during the period 1st January-31st December 2014. The standard World Health Organization/International Network for Rational Use of Drugs prescribing indicators were used to determine the prescribing practices of physicians. Published ideal standards for each of the indicators were used to identify irrational drug use. We also utilized an additional indicator to report the percentage share of antibiotics prescribed. The average number of drugs prescribed per encounter was 2.3 (SD = 1.3) (optimal value 1.6-1.8). Drugs prescribed by generic name occurred 83.1% of the time (optimal value 100%). Antibiotics and injections were prescribed 52.4% (optimal value 20.0-26.8%) and 98.0% (optimal value 13.4-24.1%) of the time respectively. Drugs prescribed from the Essential Drugs List equated to 81.5% (optimal value 100%). Out of 52.4% (n = 2262) prescriptions with antibiotics prescribed, 77.7% (n = 1758) had one antibiotic, 22.1% (n = 499) included two antibiotics, and 0.2% (n = 5) had three antibiotics. Cephalosporins were the most commonly prescribed class of antibiotics (81.5%) followed by penicillins (6.4%) and fluoroquinolones (6.2%). Among the individual antibiotics, ceftriaxone contributed the highest percentage share at 71.8% followed by cefotaxime (5.6%) and metronidazole (4.7%). The most frequently prescribed antibiotic combination was ciprofloxacin with metronidazole (52.1%). Irrational prescribing practices were common. Continuous education and training of physicians is required to ensure rational prescribing at Bahawal Victoria Hospital in the future.