Drug utilization at primary health care level in southern India

Abstract

Primary health centres provide health care to the majority of the population in developing countries. A drug utilization study was conducted for 1 y at two primary health centres in Pondicherry, India. Information on complaints, diagnosis and drugs prescribed was collected. From the 2953 prescriptions studied, it was found that on an average each patient received 2.71 drugs. Vitamins, antibiotics, analgesics and antihistamines were the most commonly used, accounting for more than 80% of the drugs prescribed. The antimicrobials which constituted one fourth of the drug consumption, comprised sulphonamides, tetracycline and cotrimoxazole. About half of the patients received injections, particularly of the vitamin B Complex and antibiotics. The results will be used to plan intervention strategies for the promotion of rational drug use.

PIP: 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.