A PROSPECTIVE OBSERVATIONAL STUDY ON PRESCRIPTION PATTERN, DRUG UTILIZATION AND AUDIT FOR THE TREATMENT OF TUBERCULOSIS IN A TERTIARY CARE HOSPITAL IN ANDHRA PRADESH

Introduction: TB ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). Tuberculosis is caused by a bacteria called Mycobacterium tuberculosis that most often affects the lungs. Tuberculosis is a curable and preventable disease. Early diagnosis and adequate treatment of infectious patients with pulmonary TB are necessary to reduce transmission of tuberculosis and ultimately to achieve elimination of TB. If TB is detected early and properly treated using a combination of medicines for 6 to 9 months, the patients quickly become noninfectious and are eventually cured. Objective: The objective of the observational study is to evaluate the prescription pattern, drug utilization and the audit of anti-TB drugs usage in a tertiary care hospital in Rajahmundry, Andhra Pradesh. Methodology: The study design is a prospective observational study. A total of 80 cases related to treatment of TB were investigated. The inclusion and exclusion criteria include patients with pulmonary TB admitted as in patients in the hospital, patients with age group 15-80years of both men and women, patients with active or inactive TB taking anti-tubercular treatment and pregnant and lactating women. The data sources include patient case sheets, prescriptions issued and discharge medication sheet, WHO guidance on essential drugs and by interacting with physicians and patients. Results and Conclusions: Men are more prone(62.5%) to TB than women(37.5%). In all age groups men are more than females among the TB patients. Hypertension ,diabetes, COPD and thyroid are more prevalent co-morbid diseases in TB patients. 4-drug combinations consisting of rifampicin, isoniazid, ethambutol and pyrazinamide are most widely prescribed(86.25%). WHO suggested 7 essential drugs for TB out of which only 4 drugs were prescribed in the hospital. In most of the cases of mono drug therapy and combination therapy, the drugs are used at larger doses than the WHO suggested doses. Hence it is suggested that the WHO recommended all essential drugs may be used either alone or in combinations at the doses suggested. Key Words: Prospective observational study, Prescription pattern, Drug utilization, Prescription audit, Anti tubercular drugs