Muhammad Tariq Aftab, Hira Tariq.
Knowledge of Guidelines of Drug Use in Geriatric Patients can Avoid High Misuse of Antibiotics in these Patients.
Pak J Med Res Jan ;55(2):51-4.

Objective: To determine the knowledge of drug prescribers, it’s impact on their prescription and the basis of their decisions in geriatric patients. Study design, settings and duration: Prospective cross sectional study in medical units of three tertiary care government hospitals of Karachi, Pakistan from 1st June till 31st August, 2014. Subjects and Methods: Two hundred seven (207)house officers, Postgraduates, Residents and Medical officers who completed their undergraduate degree programs in five different medical universities and working in three tertiary care government hospitals, were asked to complete a questionnaire to check their knowledge about the selection of medications in the geriatric patients. The questions were aimed to check the awareness of prescribers regarding different facts which should be considered before prescribing drugs in geriatric patients and to explore the choice of drugs in these patients as per standard criteria. Detail of medications which were purchased from different medical stores outside the hospital and were used in geriatric patients was collected to link the knowledge of prescriber and its impact on prescription. Same physicians filled another questionnaire to justify their prescriptions when their knowledge of the use of drugs in geriatric patients was found to be poor. Results: Assessment of knowledge of 124 prescribers (59.9% of 207 who responded the questionnaire) showed that only 32.2% knew the lower age limits of geriatric patients, 29.8% knew guidelines for drug use in elderly, 18.5% were aware of the factors effecting drug selection, 12.0% knew the factors causing over-prescription and 46.7% knew the factors influencing dose selection. Antimicrobial drugs were the most inappropriately prescribed drugs and 78.3% are prescribed irrationally. Cephalosporin was the most prescribed group and given to 71.2% of the patients. Within this group Ceftrioxone, a (3rd generation Cephalosporin) was mostly prescribed in 43.1% of the total patients. Fear was the most prevailing factor (41.1%) in prescribing an antibiotic in geriatric patients. Conclusion: Results show that poor knowledge of prescribers for appropriate use of drugs in geriatric patients results in excessive use of broad spectrum antibiotics and the decision is mostly based on illogical basis. Key words: Drug, geriatric patients, misuse, cephalosporin.

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