Adverse reactions are the recognized hazards of drug therapy and they can occur with any class of drugs and many studies revealed that the incidence is more in case of antibiotics. The main aim of this study was to detect and analyze Adverse Drug Reactions of antibiotics in inpatients of a tertiary care hospital. A prospective spontaneous reporting study by active and passive methods was carried out for a period of six months. A total of 49 ADRs were reported during the study period with male predominance (53.06%) and geriatric age group. More number of ADRs was from General Medicine and Pediatric departments in which the most affected organ systems were the GIT (38.77%) and the skin (30.61%). The antibiotic classes mostly accounted were cephalosporins (34.69%) followed by fluoroquinolones and others in which type A reactions were more compared to type B and 59.18% of them were predictable. The severity assessment revealed that most of them were moderate (63.26%) followed by mild and severe reactions. Of the reported reactions, 55.10% were definitely preventable and causality assessment was done which showed that 71.42% of the reactions were probable, possible (18.36%), definite (10.20%) and no reactions were unlikely. The study concluded that Adverse Drug Reactions to antibiotics are common and some of them resulted in increased healthcare cost due to the need of some interventions and increased length of hospital stay. The health system should promote the spontaneous reporting of Adverse Drug Reactions to antibiotics, proper documentation and periodic reporting to regional pharmacovigilance centers to ensure drug safety.

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.

In our setting, routine culture may be necessary as treatment failure with empirical therapy is likely to occur.

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