TITLE:

DRUG UTILIZATION STUDY OF URINARY TRACT INFECTION (UTI)

OBJECTIVES:
1. To study the drug utilization pattern in urinary tract infection.
2. To quantify the drug utilization in urinary tract infection in terms of defined daily dose
(DDD).
3. To obtain basic demographic information on urinary tract infection patients admitted to
the hospital during the study period.
4. To observe the associated illnesses present with urinary tract infection.
5. To observe the outcome of each patient of urinary tract infection at the time of discharge.

INTRODUCTION AND SUMMARY:
Drug utilization has been defined as the marketing, distribution, prescription and use of
drugs on society with special emphasis on the resulting medical and social consequences(1)for
the past few decades, more attention is being given to rational prescribing, drug utilization
studies are playing a major role in this regard. These studies not only detect flaws in the therapy
but also find out solutions to rectify the same.

Rational drug prescribing is defined as the use of the least number of drugs to obtain the
best possible effect in the shortest period and at a reasonable cost.(2-5)
Irrational prescription of drugs is of common occurrence in clinical practice.(6) Important
reasons are:
1. Lack of knowledge about drugs;
2. Unethical drug promotions and
3. Irrational prescribing habit by clinicians.

Monitoring of prescription and drug utilization studies could identify the associated
problems and provide feedback to the prescriber so as to create an awareness about the irrational
use of drugs. (2, 7-9)
It is necessary to define the prescribing pattern and to target the irrational prescribing
habit for sending remedial message.(10)

Hospital or community based studies aim to carry out a complete therapeutic audit to
see what is prescribed, what is the intention and with what benefit or ill effect and at what cost.
There is an extreme paucity of such studies in the international scene and they are non-existent
on our national scene.(11) Essential drugs should be accessible to all the people.(12)

Urinary Tract Infections may be wholly asymptomatic or may make the patient
desperately ill or even kill him (Campbell).
Urinary tract infections are extremely common disorders. They include infections of
kidney, bladder and the collecting systems. It is very important to realize that they may be
symptomatic. Even though they are not associated with significant mortality, they have high
mortality if complicated.(13) As such there are no significant reports to confirm the incidents of
morbidity caused by urinary tract infections.
It is very important to view the urinary tract infection seriously because of the high
morbidity and emergency of antibiotic resistant organisms.
The reason for this may be improper usage of antibiotics, inadequate dosage and
insufficient duration of treatment. In recent years it has been emphasized to do culture and
sensitivity of the urine sample before starting the antibiotic, to give the drug of choice and for
sufficient number of days and frequent follow up of the patient to identify the recurrences and
relapses.
In significant number of patients the classical symptoms of urinary tract infections are
absent.

The term urinary tract infections include the infections of kidney, ureter, bladder, prostate
etc. Earlier the term like cystitis for infections of bladder, pyelonephritis for involvement of
kidney were used. But now a days the term Urinary Tract Infections is preferred to include the
infection of urine from kidney to urethra.(14)

MATERIALS AND METHOD
The present study will be conducted after obtaining the permission of ethical committee
of our institution, Azeezia Institute of Medical Sciences and Research, Kollam, Kerala. The
present study included patients of urinary tract infection who were admitted to the hospital.

It will a six month (July 2013 to December 2013) non-interventional retrospective study,
observational study and the data will be collected from the Medical Record Room. The proforma
for collecting the data is designed. The data collected will be subjected to descriptive statistical
analysis using Microsoft excel.
Anatomical therapeutic chemical (ATC) classification and defined daily dose (DDD)
system will be used for the quantification of drug utilization. Following formula of defined daily
dose will be used for calculation and results obtained will be expressed in terms of defined daily
dose per 1000 inhabitants per day (DDD / 1000 inhabitants / day).(15)




Formula

Total use of a drug(mg) during
the study period
DDD/1000inhabitants /day = -------------------------------------------- X 1000
DDD (mg) x Duration of study
x Total sample size

DDD/1000 inhabitants/day may provide a rough estimate of the proportion of the study
population that may be treated daily with certain drugs.

IMPLICATIONS
The present study has been proposed with the aim to study the drug utilization of UTI and to
assess the pattern of drug utilization of UTI.

RISK FACTORS: There are no risk factors as this is not an interventional study; it is a cross
sectional retrospective drug utilization study.

ETHICAL ISSUES:Permission will be obtained from the ethics committee of the institution for
conducting the study. We are aware of the values set by the ethical committee and give my
assurance regarding my compliance.

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