Antibiotic prophylaxis in organophosphorus poisoning: A study of health and economic outcomes

Abstract

Organophosphorus poisoning (OPP) is a major concern for developing countries. There are no guidelines for the prophylactic use of antibiotics in the management of OPP which in such critical cases might add to the economic burden of the patients as well as antibiotic resistance. We compared the health and economic outcomes in patients prescribed with prophylactic antibiotics with respect to the patients not prescribed with any antibiotics. A retrospective observational study was carried out for two years for patients admitted to ICU with OPP. Patients were graded for severity of OPP, and divided into two groups based on prophylactic prescription and no prescription of antibiotics. The length of stay (LOS), hospitalization cost and outcomes were measured and compared between the two groups using statistical tests. Out of the 254 patients observed, 108 were prescribed with prophylactic antibiotics and 94 were not prescribed with any antibiotic. There was a significant difference between LOS, cost of treatment and outcomes in the two groups ( < 0.001). When antibiotics were not prescribed, the odds of improvement was 1.854 times higher compared to those who received prophylactic antibiotics although after adjusting for severity of poisoning, significance was lost. On an average, 2-3 antibiotics were prescribed to every patient in the first group. OPP is an important health concern where issues of antibiotic misuse and overuse are practiced. Our study suggested that systemic antibiotic prophylaxis did not offer any advantage over non-use of any antibiotics in patients with OPP.

A cross sectional study of various types of acute poisoning; pharmacological management and their outcome in a tertiary care hospital

“…Various clinical trials did not prove any benefit of antibiotic therapy for acute poisonings especially in snakebites and organophosphate poisoning. 23,24 In the present study, 68.67% drugs were prescribed by generic name and 26.51% were prescribed by brand name. Drugs prescribed more by brand names adds more cost to the patient and hospital.…”

“…The proportion of death that occurred in this study was smaller than study done in Bengal 15.03% 3 , study by Vaidya et al 20%, Ramesha et al 15.4% and Singh et al 17.3%, respectively. [19][20][21][22][23][24][25][26] One of the reasons for the lesser mortality reported probably could be due to the fact that the outcome of patients, who took premature discharge is unknown and could not be taken for analysis like in cases of DAMA and Absconded. The mortality rate in this study was higher than study done in Maharashtra and Andhra Pradesh with 9.8% and 8.47% mortality rate, respectively.…”

Study of Drug Utilization on Acute Poisoning Cases Treated at Tertiary Care Hospital

“…Various clinical trials did not prove any benefit of antibiotic therapy for acute poisonings especially in organophosphate poisoning and snakebites. [21,22] In this study High mortality could be because of various reasons like lack of information regarding the poison agent and the dose/amount consumed in some cases, long time interval between toxic exposure and hospital arrival, highly toxic pesticide ingestions, lethal snakebite envenomations and finally lack of specific antidotes. Many patients were referred when their conditions had become worse from hospitals with a delay.…”

A Retrospective Study on Drug Utilization Pattern of Poisoning Cases Admitted in a Tertiary Care Teaching Hospital

“…are prescribed, dispensed, or sold inappropriately [35]. Antibiotic resistance stands a serious threat to humans and undermines the global economy.…”