To evaluate potentially inappropriate medications (PIM) and potential prescribing omission (PPO) among hospitalized geriatric patients using STOPP and START criteria respectively, to study morbidity and drug use pattern and to collect feedback from the physicians to improve rational drug therapy. Method: OLOGY: A prospective observational study was carried out for a period of 12 months among patients aged ≥65 years. The study was conducted in three phases. During first phase, the patient's data were recorded in data collection form and analyzed using STOPP/START criteria. During second phase, the results of first phase were introduced to the physicians along with the criteria and feedback form. During third phase, the prescriptions were re-assessed to determine the acceptance of criteria. Results: A total of 210 patients were included in the study during the entire study period with 108 patients in first phase and 102 patients in third phase. The prevalence of PIM detected using STOPP criteria during first and third phase were 43.5% and 40.2% respectively. Similarly the prevalence of PPO detected using START criteria during first and third phase were 52.8% and 53.9% respectively. Conclusion:The study shows that there is high prevalence of PIM and PPO among hospitalized geriatric patients which are unacceptable and there should be consensus for considering such evidence based screening tools while prescribing drugs to elder peoples.

The study shows high prevalence of prescribing PIMs in hospitalized elderly patients; PIM also caused incidence of ADEs; and serious drug-drug interactions were scarce among the patients.

The contemporary profile of treatment patterns for patients with ACS indicates an improved adherence to the guidelines. The alarmingly high rate of modifiable risk factors remains a cause of concern and a challenge that needs to be tackled, as better control of cardiovascular risk factors is expected to have a favorable impact on the incidence of ACS.

Background:The cephalosporins are a large group of related β-lactam antimicrobial agents with broad spectrum of activity. Drug Utilization and Evaluation (DUE) is an ongoing, structured process to analyse the pattern of drug administration in various practice settings, including hospitals in relation to guidelines or predetermined standards thereby promoting the appropriate and effective use of drugs. Methods: This prospective interventional study was conducted for a duration of six months among the in-patients of various departments of a multispecialty hospital located in Kerala, India. Cephalosporins were evaluated. Results: Study conducted over a period of 6 months revealed that most of the therapy was definite 45% (n = 120) followed by empirical 32% (n = 85) and the least type was prophylactic 23% (n = 62) (ᵡ2 = 16.965, d.f = 2, p < 0.0010). Inappropriate use of cephalosporins were noted in 30 out of 267 cases (11.2%). Among these majority 93% (n = 28) were wrong drug selection followed with wrong days of therapy and failure of deescalation, 3.33% (n = 1) each. In 13% (n = 8) cases, drug was given beyond the actual duration. De-escalation was not done in 4% (n = 3) cases and in 8% (n = 5) cases the treatment was done against the culture and sensitivity pattern. The most common drug used in combination with cephalosporins was metronidazole (36%). Conclusion: Extensive use of third generation cephalosporin was observed in the study with facts and figures revealing their inappropriate use. This climaxes the need of continuous educational intervention by clinical pharmacist along with the modification of hospital antibiotic policy.

High prevalence of ESBL-producing organisms is evident in the study setting implicating the necessity to report the ESBL production along with the routine sensitivity reports supplemented with control measures which can assist a clinician in prescribing appropriate antibiotics.