Drug utilization at primary health care level in southern India
Bapna, J.S.; Tekur, U.; Gitanjali, B.; Shashindran, C.H.; Pradhan, S.C.; Thulasimani, M.; Tomson, G.
European Journal of Clinical Pharmacology 43(4): 413-415
1992
ISSN/ISBN: 0031-6970 PMID: 1451722 DOI: 10.1007/bf02220618Document Number: 325296
Records from 2 of the 8 primary health care clinics (PHCs) in Pondicherry, India, were surveyed one day per month in 1988 by medical graduates to determine drug utilization. 2953 patients treated during the morning hours received 8021 prescriptions, an average of 2.71 each. The most commonly prescribed drugs were vitamins (24.7% of total drugs), antimicrobials (24.3% of drugs, 66.2% of patients), analgesics (19.9% of drugs) and antihistamines (10.3%). The most prevalent diagnoses were would infection (20.5%), myalgia (11.3%), urinary tract infections (10.2%), pain, skin diseases, cold and diarrhea. Asthma, worms and fever of unknown origin were found in 5% or fewer patients. Among antimicrobials, the most commonly prescribed were sulfonamides, tetracycline, and cotrimoxazole. Children received more antibiotics than adults. Chloramphenicol was given to 42 patients, 28 of them children. Penicillin made up only 6.4% of the antibiotics given. 32.8% of the antibiotics were administered intramuscularly, including 355 tetracycline injections. B-vitamin complex was also injected intramuscularly in 474 patients. Both consumers and practitioners in developing locales must be informed that injections, particularly of agents such as tetracycline and vitamins which are safer and cheaper to give orally, are not the administration route of choice for all medications. A safer antibiotic than chloramphenicol should be chosen for serious infections, especially in pediatrics.
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