Drug Utilization Study on Acute Poisoning Cases Treated at a Tertiary Care Hospital in Western Part of India

Background: Acute poisoning is a common medical emergency. This study was designed to investigate the pattern of drug utilization, poisoning agents, and outcome in patients with acute poisoning treated at a tertiary care teaching hospital in Vadodara, west of India. Methods: This prospective cross sectional drug utilization study was carried out on patients with diagnosis of acute poisoning admitted to emergency department of Sir Shree Sayajirao General Hospital during October, 2013 to March, 2014. Results:During 6 months, 340 acute poisoning cases were enrolled, out of which 216 cases (63.5%) were men. Mean age of the patients was 31.9 ± 12.7 years. Commonest mode of poisoning was intentional (suicidal), which was observed in 62.1% of cases. Pesticides were the most common cause of poisoning (40%), followed by venomous animal exposures (25.9%). Fifty-six patients (16.5%) died. A significantly higher number of deaths was seen in intentional poisonings compared to accidental poisonings (24.2% vs. 3.9%; P < 0.001). The most common symptomatic treatments given to the patients were antiemetics (97.9%), H2 blockers (89.1%) and antimicrobials (75%s). Atropine (47.7%), pralidoxime (42.4%) and anti-snake venom (15%) were the most commonly prescribed specific antidotes. Median number of drugs per encounter was 8 [range: 1 to 23]. Over half of drugs were prescribed by generic and nearly one-thirds of drugs were prescribed by brand name. Conclusion: Use of antimicrobial medicines for poisoned patients was too high and irrational.  Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. Educational programs with emphasis on preventive measures for toxic exposures are necessary to create awareness among the general public.