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A Study and Report on Role And Impact Of Clinical Pharmacist in assessment of Prescribing Cascades In Antibiotics Usage For Infectious Diseases in Promotion of Rational Drug Usage

Mekkanti Manasa Rekha, Rashi L, Karishma Parveen, Priyanka Dey, Hamin Jahan, Sabitha Sujeet, Dr C.D Saraswathi



A Prescription cascade occur when the healthcare providers fail to recognise that the new symptoms are actually the side effects of the medications under treatment. The study was based on the role and impact of clinical pharmacist in assessment of prescribing cascades in antibiotics usage for infectious diseases in department of general medicines and paediatric department at ESI hospital, Indiranagar, Bangalore, Karnataka, India. The main motto of the study was to evaluate prescribing cascades in antibiotics with infectious disease patients and report on contributing factors for prescribing cascades, identification of drug related problems(DRP), to enhance the awareness of prescribing cascades in antibiotics among health care professionals. It is a hospital-based, prospective, cross-sectional and observational study. The present study reveals that age group > 50 (47.22%) were reported with the risk of drug related problems. In this study  120 patient's prescriptions was analyzed for antibiotics prescribing cascades, which  showed  the major population enrolled with PC were females 66(54.98%) compared with males 54(45.02%). Among 120 patients selected within study population majority were illiterates 40(66.66%) and 80(33.33%) were literates. Among the study population,60(50%) were hospitalized for 5-10 days.40(33.33%) were hospitalized for less than 5 days and 20(16.66%) were hospitalized for more than 10 days. Whereas mean hospital stay was 7 days. During the study period it was observed that, among   antibiotic prescribed, Cephalosporin’s 16(44.44%) was the class with most prescribing cascade, followed by penicillin8(22.22%),Fluroquinolone4(11.11%), and Tetracycline 2(5.5%). Our study concluded that prescribing cascades can proceed from being problematic, to appropriate when managed by interventions like dosage reduction and alternative medications, and active involvement of well trained clinical pharmacist for detecting, monitoring and awareness programs to the healthcare providers, dispensers and public regarding prescribing cascades.



Keywords:  Prescribing cascades , Prospective, Cross-sectional, Adverse drug events .


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