A PROSPECTIVE STUDY OF DENTAL DISEASE PATTERN AND DRUG UTILIZATION AT THE DENTAL DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL IN EASTERN NEPAL

Abstract

To find out the pattern of dental diseases and drug utilization at dental out patient
department (OPD) of B.P. Koirala Institute of Health Sciences (BPKIHS), a tertiary
care hospital. A prospective prescription audit was conducted for a period of 10 days
in the dental OPD and the data was analyzed using WHO drug indicators. The total
number of prescriptions analyzed were 279. Dental caries (37%), Periodontitis (14%)
and chronic gingivitis (11%) were the most common diseases with a maximum incidence
between the age groups of 9 to 40 years. Mean number of drugs per prescription was
2.79. Of the total prescriptions, 223 (79.9%) had 314 antimicrobial agents (AMA)
constituting 40.3% of total drugs prescribed. The mean number of antimicrobial agents
per prescription was 1.13. The most commonly prescribed antimicrobial agents was
amoxycillin (33.1%) followed by metronidazole (24.9%), doxycycline (17.2%) and
tinidazole (12.7%). Fixed dose drug combination of amoxycillin + cloxacillin (26) and
ampicillin + cloxacillin (10) were prescribed in 36 of the prescriptions. Povidone iodine
gargle (41.2%) was the most commonly prescribed oropharyngeal preparation followed
by Chlorhexidine gluconate mouthwash (32.4%). Non- steroidal anti-inflammatory
agents (20.66%), multi-vitamins (19.51%) and oropharyngeal preparations (17.45%)
constituted the rest of the drugs prescribed. Diclofenac (60.86%) was the most
commonly prescribed among NSAIDs and fixed dose drug combination of ibuprofen
and paracetamol was prescribed in 19 of the prescriptions. All drugs were given by
oral route (except for gentamicin in one prescription) and were prescribed under
brand names. None of the prescriptions had instructions whether the drug should be
taken before or after food. The results indicate that dental caries was the most common
dental disease, anti-microbial agents were prescribed to majority of the patients and
constituted a little less than half of the total drugs prescribed. Commonly used anti-microbial agent was amoxycillin which in two thirds of the cases was prescribed as an
fixed dose drug combination. The high incidence of anti-microbial agent prescribing
may be modified by a feedback to the prescribers.
Key words: Dental morbidity, prescribing pattern, drug utilization, dental OPD,
antimicrobial agents.