Background: It is imperative to evaluate and monitor the drug use patterns from time to time and make suitable modifications in prescribing patterns to increase the therapeutic benefit and decrease the adverse effects to optimize the medical services to the patients. Keeping this scenario in mind, the present study was undertaken. Aims and Objectives: To evaluate pattern of drug use in ENT (ear, nose, throat) outpatient department (OPD) of a rural tertiary care teaching hospital using WHO core drug prescribing indicators. Material and Methods: A cross-sectional observational study was carried for 3 months in the ENT OPD of SRTR Government Medical, Ambajogai, Beed, Maharashtra, India. Data were collected from the prescriptions written by treating surgeons and interviewing patients regarding their understanding of dosage forms. Results: A total of 3342 drugs were prescribed through 855 prescriptions with average number of drugs per prescription being 3.90 and average number of 2.5 drugs dispensed per prescription. Majority (59.64%) of the patients were male. Antibiotics were the most frequently prescribed drugs (24.86%) followed by nonsteroidal anti-inflammatory drugs (23.60%), gastroprotective agents (22.55%), and antihistaminics (19.92%). Antibiotics were prescribed in 831 prescriptions (97.19%). Most common route of drug administration was oral (97.75%) followed by topical. Drugs were mostly (80%) prescribed by brand names. Conclusion: The present study highlights the problems of polypharmacy, overuse of brand names, and symptomatic rather than definitive approach toward patient management. Interventions to rectify overprescription of antibiotics, use of brand names, inadequate labeling of drugs are necessary to improve rational drug use. Standard treatment guidelines, hospital formulary, and educational intervention become essential to modify this behavior to benefit the patient.

a b s t r a c tObjectives: The study was carried out with the aim of evaluation of the adverse drug reaction profile of anti-snake venom serum (ASV) in a rural tertiary care hospital. Methods: An observational study was conducted in SRTR Medical College, Ambajogai, Maharashtra, India. A total number of 296 indoor case papers of snake bite from February to September 2011 and June to August 2012 were retrieved from the record section and the antivenom reactions were assessed. In addition, basic epidemiological data and prescribing practices of ASV were also analyzed. Results: Vasculotoxic snake bites were more common (50.61%) than neuroparalytic ones (22.56%). Mild envenomation was the commonest presentation. A total of 92 (56.10%) patients who received ASV suffered from antivenom reactions. The most common nature of reaction was chills, rigors (69.56%) followed by nausea and vomiting (34.8%). 10e15% patients suffered from moderate to severe reactions like hypotension and sudden respiratory arrest. We did not find any dose response relationship of ASV to risk of reactions (odds ratio 0.37). Intradermal sensitivity test was performed in about 72% cases. Conclusion: Our study showed a higher incidence of reactions to ASV at our institute.

Background: To evaluate prescribing pattern of antimicrobial agents in indoor patients of medicine and surgery department of SBH Government Medical College, Dhule. Methods: This was a retrospective cross sectional study carried over a period of 3 months. The patients who were admitted and received antimicrobial therapy in department of Medicine and Surgery were randomly selected and included in the study. The case record sheet and drug chart were obtained from Medical Record Section of the Hospital. The data was collected using case record form specially prepared for the study. The cases were categorised according to slightly Modified Kunin’s Criteria. Results: Total numbers of patients receiving antimicrobial therapy were 130 in medicine department and 93 in surgery department. Most commonly prescribed antimicrobial agent was cefotaxime (21.7%) in medicine and metronidazole in surgery (30.6%) department. The average number of antimicrobials per patient was found to be 1.7 and 3.02 in medicine and surgery department respectively. The switch on therapy from parenteral to oral route was employed in 16.15% patients in medicine department and 11.82% patients in surgery department. As per Kunin’s modified criteria, 66.2% and 58.06% patients received antimicrobial therapy appropriately in Medicine and surgery department respectively. Conclusion: This study highlights the problem of over-prescription of antibiotics and a trend towards polypharmacy. The interventions to rectify the problem of inappropriate use of antimicrobial agents are needed to make therapy more rational and cost effective. [Int J Basic Clin Pharmacol 2013; 2(3.000): 281-285

||ABSTRACT Background: Children constitute 40% of India's population. They tend to suffer more frequently from illnesses, when compared with adults and elderly. Most of these illnesses are self-limiting. There are reports that these illnesses are treated inappropriately leading to polypharmacy. Children are more vulnerable to the various adverse events related to the use of drugs. Though many studies have been carried out to evaluate the drug prescribing pattern in adult patients, but similar studies in paediatric population are limited. Aims and Objective: To evaluate the pattern of drug prescribing and dispensing in pediatric outpatient clinic in a rural tertiary-care teaching hospital using WHO Core drug use indicators. Materials and Methods: A cross-sectional study was carried out in the pediatric outpatient clinic of Swami Ramanand Teerth Rural (SRTR) Medical College, Ambajogai, Maharashtra, India. Data were collected by scrutinizing the prescriptions written by the treating physician in pediatric outpatient clinic, using WHO core drug use indicators and by interviewing parents of 300 children attending outpatient clinic. Result: The average number of drugs per prescription was 3.4 and actually dispensed was 2.5. There was a high trend of using brand names (49.6% of prescriptions) while prescribing than generic names. Use of antibiotics (60.6% of prescriptions) was frequent, but injection use (0.8% of prescriptions) was very low. A high number of drugs prescribed (77.5%) conformed to WHO list of essential medicines for children and were dispensed (69%) by the hospital pharmacy. The parents' understanding of the correct usage of drugs was low (59%), and only 10.5% of drugs were adequately labeled. The copy of an essential drugs list was not available. The availability of essential drugs was 75%. Conclusion: This study highlights the problem of overprescribing of antibiotics, inadequate labeling, and a trend toward polypharmacy. The prescribing from WHO list of essential medicines for children was fair; the use of injections was low. Interventions to rectify overprescription of antibiotics, use of brand names, and inadequate labeling of drugs is necessary to improve rational drug use.