Keywords
Pattern, Prescription, urinary tract infection, adverse drug reaction, reproductive.
Urinary tract infection is considered a common bacterial infection. Nowadays there is an increase in the irrational and inappropriate use of drugs.
Adverse drug reactions have been reported to be a main cause of morbidity, hospital admission, and sometimes death. For this, it is very important to do the analysis of prescriptions and to see the adverse drug reactions due to the prescribed drugs.
1.
To determine the prescribing pattern of drugs used in urinary tract infections of the reproductive age group (15-44).
2.To identify adverse reactions due to drugs used for UTI of reproductive age group (15-44).
3.To observe the pattern of combination therapy for urinary tract patients of reproductive age group.
4.To analyze the Fixed Drug Combination.
It is a retrospective observational study. Data will be collected from 175 prescription papers. Data will be collected from the medical record section. The study will include prescriptions of UTI for Females of the reproductive age group (15-44 years).
Pattern, Prescription, urinary tract infection, adverse drug reaction, reproductive.
Urinary tract infection occurs when microbial pathogens are present in the urinary tract. It affects both genders but it is more common in women and it affects the females of the reproductive age group (15-44 years) mostly. It may be because of their anatomy and reproductive physiology. Women get urinary tract infections more often because their urethra is shorter than men's and it may be due to delay in micturition, use of contraceptives, and sexual activity.
The kidneys and the ureter are involved in upper urinary tract infections, while the bladder and urethra are involved in lower urinary tract infections.1
Clinically urinary tract infection is classified into – Complicated/uncomplicated and primary/recurrent.1 organisms that are responsible for urinary tract infection are “Escherichia coli, Staphylococcus, Streptococcus, Klebsiella, Proteus, Corynebacterium, Neisseria and Pseudomonas species”.2
Treatment of urinary tract infections may vary according to location, age of patient, and severity of presentation in the community. After the urine culture sensitivity test, empiric therapy for UTI should be initiated. The choice of medication should be determined by identifying the pathogen, assessing sensitivity through urine culture, and considering the patient's comorbid conditions.3
Uncomplicated cystitis:
Nitrofurantoin 100mg - 5 days is the 1st line treatment and
2nd line treatment for uncomplicated cystitis: Trimethoprim/Sulfamethoxazole - 3 days,
oral Cephalexin 500mg - 3-7 days, or Fosfomycin 3 g -1 day.
Complicated cystitis:
Nitrofurantoin 100mg - 7 days is the 1st line treatment and
Trimethoprim/Sulfamethoxazole -7 days, or oral Cephalexin 500 mg - 7 days, or Fosfomycin 3g every 48 hours for 3 doses is the 2nd line treatment.4
Most commonly Nitrofurantoin and Sulfonamides are used in the treatment of UTI in reproductive age groups and pregnant women.5
RELATED ADVERSE DRUG REACTIONS:
(1) Adverse drug reactions of Nitrofurantoin:
Nausea, loss of appetite, vomiting and diarrhea
Severe adverse reactions are:
Pulmonary toxicity (acute, subacute, chronic pulmonary reaction)
liver injuries due to nitrofurantoin
Peripheral neuropathy – is rare and it is mostly seen in patients with poor renal function and on prolonged use.6
(2) Adverse drug reactions of Sulfonamides:
Sulfonamide-induced liver injury- it can be hepatocellular or cholestatic hypersensitivity reactions include fever, facial edema, lymphadenopathy, arthralgias, rash, eosinophilia, or atypical lymphocytosis (or both).
diarrhea, nausea, headaches, and dizziness, skin rash.
Rare adverse reactions:
severe allergic skin rashes, aplastic anemia, pancreatitis, serum sickness, Stevens-Johnson syndrome, agranulocytosis, nephritis, confusion seizures, and ataxia.7
Nowadays, it is necessary to evaluate prescriptions due to the rapid changes in the prescriptions of diseases.
To analyze the irrational and inappropriate use of drugs this study is necessary.
For the improvement of patient compliance and to find out what type of adverse reactions are seen in reproductive age group female (15-44yrs) UTI patients due to prescribed drugs.
To analyze the prescription pattern and adverse drug reactions of drugs used in urinary tract infections of reproductive age group (15-44).
Study design: Retrospective Observational Study
Study population: 175
Study duration: 18 Months (February 2024 – August 2025)
The study will include prescriptions of UTI for Females of the reproductive age group (15-44 years).
Daniel Formula:
Z = statistic for a level of confidence =1.96
P = Prevalence of urinary tract infection =33.54% = 0.3354
d = Desired error of margin = 7% = 0.07
Study reference: Pritam Pardeshi
Statistical methods: Student's t-test, Chi-square Test.
Software used: SPSS 27.0 version
Study design: Retrospective observational study.
We will collect recorded files of patients from the medical record section. And Analyze prescriptions and adverse drug reactions of patients. Table 1 details the parameters included in the study. Data will be analyzed using a suitable Statistical Test SPSS- 20.
Nowadays irrational and inappropriate use of drugs is a major concern. Irrational drug use may cause adverse consequences including drug resistance and adverse drug reactions.8,9For the improvement of patient compliance, it is very important to analyze prescription patterns and adverse drug reactions (ADRs). The benefits of our research will be patient care improvement and risk assessment.
This analysis is for the use of evidence-based medicine in tertiary care centers, to fulfill the drug information needs of the physician and also for improvement in the quality of healthcare by giving feedback to prescribers. This is an observational, retrospective study that will aim at the analysis of drug patterns and adverse drug reactions due to drug prescription in urinary tract infections at tertiary health care centers.
1. Ethical Committee approval is obtained.
Consent to participate:
As it is a retrospective there is no requirement asked from our institutional Ethical committee for getting the data of the past patient it is waived off for this study, Also we have taken proper permission and a letter from the concerned faculty of Hospital (CMS) from the medical record section for the previous data.
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Is the rationale for, and objectives of, the study clearly described?
No
Is the study design appropriate for the research question?
Yes
Are sufficient details of the methods provided to allow replication by others?
No
Are the datasets clearly presented in a useable and accessible format?
No
References
1. Saber S, Yasmin N, Alam M, Hossain M, et al.: Study on Urinary Tract Infection Among Females of Reproductive Age Group in Tertiary Care Teaching Hospital, Dhaka, Bangladesh. European Journal of Medical and Health Sciences. 2021; 3 (1): 85-89 Publisher Full TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: Geriatrics, Medication safety management
Is the rationale for, and objectives of, the study clearly described?
No
Is the study design appropriate for the research question?
No
Are sufficient details of the methods provided to allow replication by others?
No
Are the datasets clearly presented in a useable and accessible format?
No
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Clinical microbiology, urinary tract infections, E.coli pathogenesis, antibiotic activity in vitro and in vivo
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | |||
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