A Study on the Drug Utilization Pattern in Patients with Chronic Kidney Disease with Emphasis on Antibiotics

Objective: To study and describe the utilization pattern of various classes of drugs including antibiotics in patients with chronic kidney disease (CKD). Materials and Methods: A total of 185 CKD patients were finally recruited after strictly obeying the selection criteria in this cross-sectional, observational study that was conducted over a period of 6 months in Nephrology Department of a tertiary care teaching hospital. Relevant data were extracted by interviewing the patients and from prescriptions, case records, and investigational reports. Results: Mean age of CKD patients was 45.81 ± 11.16 with male predominance (58%). CKD Stage III comprised of the maximum number (28%) of patients. Polypharmacy was executed in 83% of these patients. Hypertension (95%), diabetes (87%), and anemia (86%) are the most common co-morbidities. The five most frequently prescribed drugs were diuretics (100%), anti-ulcer agents like proton pump inhibitors and H 2 blockers (98%), anti-hypertensives (95%), vitamins and minerals supplements including calcium (92%), and hematinics (85%). Infectious diseases like respiratory tract infection (37%) and urinary tract infection (34%) had shown to have a high prevalence in CKD patients. Cefoperazone, metronidazole, piperacillin + tazobactam were the most prescribed parenteral antibiotics. Azithromycin and levofloxacin were the extensively used oral antibiotics. Conclusion: This study demonstrates the variability of drug utilization in CKD patients. Drug utilization studies on a regular basis give a framework to pharmaceutical companies and healthcare providers and help to build management strategies. However, the right choice of drugs and inappropriate doses will reduce the incidence of nephrotoxicity and ultimately result better clinical outcomes. Managing infections and prescribing antibiotics in CKD are crucial and hence claim rationalization of the use of antibiotics to improve the quality of life of CKD patients.