Abstract

DRUG UTILIZATION EVALUATION AND PRESCRIPTION ANALYSIS FUNGAL INFECTION IN A DERMATOLOGIC DEPARTMENT: A CONCURRENT OBSERVATIONAL STUDY

Dr. Raj Patel*, Dr. Janvi Patel, Dr. Margi Gajjar, Dr. Ishangi Patel, Dr. Sangatit Patel

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Abstract

Background: Fungal infection or Mycoses is usually caused by the parasitic microorganism called fungi that affect skin and mucous membrane along with generation of systemic infections of various internal organs.[8] The degree of fungal infection ranges from superficial infection characterized by involvement of outer layer of the stratum corneum of the skin to deep infection involving the brain, heart, lungs, liver, spleen, and kidneys. Inappropriate use of anti-fungal agents is implicated in the development of anti-fungal resistance and can lead to adverse outcomes like persistent infections, unnecessary exposure, and increased cost. However, data on anti-fungal consumption in high-risk areas is scarce. Such data are essential to address public health problems related to the effectiveness of antifungal medications.[32] Aims and Objectives: To assess drug usage of Fungal Infection as a tool for ensuring rational drug therapy by using WHO core prescribing indicators. Methodology: A concurrent observational study was performed on patients of either gender treated for Fungal Infection at out-patients visiting dermatology department of Dr Sohana‟s Skin and Laser Clinic, Nadiad after the approval of ethics committee. Drug utilization evaluation was performed using WHO core prescribing indicators. Results: 150 patients were involved in this study. The drug utilization study showed that female patients (51.33%) visiting the dermatologic clinic were more as compared to male patients. Most of the patients were in the age group of 21 to 30 years which constitute about 26%. Out of 150 Patients, Tinea Corporis (79.33%) was mostly found fungal infection. 8.66% patients were found of fungal infection with other comorbidities followed by Tinea Cruris. Total 150 Prescriptions contained 456 drugs. Out of which, 292 drugs were antifungal agents and 164 were supportive drug treatment. The Most common class of anti-fungal agents prescribed were Azoles which includes Luliconazole (29.60%) and Itraconazole (26.31%) etc followed by Antifungal antibiotics such as Griseofulvin (1.53%), Topical antifungal agents such as ketoconazole-zinc Pyrithione (0.43%), and allylamine such as Terbinafine (0.65%). Supportive Treatment includes Anti-Histaminic such as levocetirizine (23.68%), Desloratadine (3.50%) and Vitamins and Minerals supplements. Conclusion: Rational use of antibiotics was observed with fungal. It was observed that drugs were not prescribed by generic name in prescription of patients with Fungal disease. Antifungal drugs were not prescribed from NLEM. Thus, to promote rational use of drugs and to encourage evidencebased prescribing, practice of polypharmacy must be reduced, drugs must be prescribed from NLEM and by generic name.

Keywords: Fungal Infection, Drug utilization review, Prescription, Dermatology.