Journal of Research in Pharmacy Practice

Abstract Cancer is a global health concern with growing incidence worldwide. Chemotherapy is the main treatment modality in many malignancies. This study aimed at evaluation of antineoplastic prescribing pattern and prescription-writing quality in the capital city of Iran.
Methods: All dispensed chemotherapy prescriptions by four main authorized pharmacies in Tehran during 1 month were targeted. Prescriptions with no antineoplastic medications or written by specialties other than oncology-related fields were excluded from the study. From the total 10,944 eligible prescriptions, 2736 (25%) prescriptions were selected randomly for data extraction.
Findings: Total 5784 antineoplastic medications were written by 239 physicians; most of them were adult hematologist–oncologist (69.0%) and male (86.6%). Each prescription contained an average of 1.8 (±0.9) antineoplastic medications. The most widely prescribed antineoplastic agents were cyclophosphamide (16.2%), fluorouracil (15.2%), doxorubicin (12.8%), and oxaliplatin (11.0%). The quality of prescription writing was poor; diagnosis, drug dosing, treatment schedule, and instructions were mostly absent. Sixty percent of drugs were written in brand names.
Conclusion: The prescribing writing quality was poor and patients were at great risk of medication errors. Prompt action including policies and educational strategies should be taken to assure effective and safe patient treatment with antineoplastic medications.

Abstract Objective: The objective was to quantify the specialists’ prescription pattern in Iran and 
to point out the prescribing behavioral differences among several specialties.
Methods: A retrospective cross‑sectional study was carried out on the claim data. National 
prescription data were obtained on the basis of the claims that the pharmacies submitted 
to the insurers during 1 year period of the study. More than 85 million prescriptions were 
analyzed using “Rx‑Analyst” software that is designed and applied by National Committee 
of Rational Use of Medicines in Iran. Specified medical specialties were considered and the 
World Health Organization prescription indicators were used to evaluate the physicians’ 
prescribing behavior.
Findings: Average items per prescription were ranged from 3.68 in cardiologists’ to 2.06 
in dermatologists’ prescriptions. The highest and the lowest mean price were belonged to 
neurologists’ and ophthalmologists’ prescriptions, respectively. In addition, 45% of patients 
received antibiotics, 41% of patients received injectable form of drugs, and 23% received 
corticosteroids. A high tendency toward prescribing corticosteroids and antibiotics as well 
as an injectable form of medicines was observed among general physicians.
Conclusion: There is an inevitable need to improve prescription habits among different 
specialties, especially among general practitioners. This causes the policymakers to put more 
emphasis on priorities such as continuous education.

Abstract Objective: The purpose of this study is to analyze the antibiotic sensitivity pattern of 
microorganisms, to study the antibiotic usage pattern, and to conduct a cost‑effectiveness 
analysis (CEA) for the antibiotics prescribed in a tertiary care teaching hospital in south India.
Methods: This prospective study was carried out in the General Medicine and Pulmonology 
departments of the hospital for a period of 6 months. The study was carried out in three 
phases: A prospective analysis to check the sensitivity pattern of microorganisms to various 
antibiotics, data extraction and determining the cost of antibiotics and finally evaluation of 
the sensitivity pattern of microorganisms and the antibiotic usage. A total of 796 documented 
records were analyzed.
Findings: It was found that Escherichia coli was the major organism identified in 36.4% of 
the isolated specimens, followed by Klebsiella sp. (18.9%), Streptococcus pneumoniae (15.8%),
Staphylococcus aureus (12.4%), and Pseudomonas (9.3%). The sensitivity pattern data of the 
prospective study revealed that E.coli was highly sensitive to Amikacin (99.3%), Klebsiella to 
Amikacin (93.8%), Pseudomonas to Meropenem (97.6%), and S. pneumoniae to Ofloxacin (93.8%). 
In the prescribing pattern study, it was found that the most common disease (21.2%) was 
found to be lower respiratory tract infection in 51 patients. Cephalosporins(73%), in particular 
Ceftriaxone (63.5%) was highly prescribed, followed by fluoroquinolones(53.9%). In the CEA, 
it was revealed that Ceftriaxone was the cost‑effective antibiotic with a cost‑effectiveness 
ratio (CER) of 78.27 compared to Levofloxacin, which had a CER of 95.13.
Conclusion: Continuous surveillance of susceptibility testing is necessary for cost‑effective 
customization of empiric antibiotic therapy. Furthermore, reliable statistics on antibiotic 
resistance and policies should be made available.