Drug Use Evaluations and Result of Implementations of the Antibiotics Replacement with Fah-ta-lai-chon (Andrographis panicula) Policy in Upper Respiratory tract Infection and Acute Diarrhea Treatment at Phimai Hospital, Nakhonratchasima.

Abstract

Retrospective descriptive study was conducted in this study. This study aimed to evaluate the appropriate drug use and quantity of Fah-ta-lai-chon (Andrographis panicula) capsules in Upper Respiratory tract Infection (URI) and Acute Diarrhea (AD) Treatment at Phimai Hospital Nakhonratchasima after the implementation of the antibiotics replacement with Fah-ta-lai-chon policy. The data were collected from review the outpatient medical records of patient whose age over 12 with the diagnosis in either URI or AD. The outpatient medical records in 2016 were examined comparatively to in 2017 (prior to use this policy). Dose regimen, re-treatment after initial treatment within 7 day, and its safety were investigated for drug use evaluation. Data were summarized as frequencies and percentage. The quantity data were analyzed by Chi-square with 95 % confidential.

Dose regimen and re-treatment after initial treatment within 7 day were also considered in the appropriate drug use evaluation. In URI group, only 1.96 percent of the dose regimen in prescription following national drug list was found and there was re-treatment patient after initial treatment within 7 day 37 patients (6.58 percent) whereas the re-treatment patient in AD group had totally 1 patient (11.11 percent). Safety of drug use, the prescriptions with contraindication and caution particularly in drug interaction risk were found in 10 patients (1.75 percent). Following policy implementation, it indicated that Fah-ta-lai-chon capsules were used increasingly to replace antibiotics in URI and AD treatment (P < 0.001 and P 0.022 in URI and AD, respectively). It was notice that the use of sole Fah-ta-lai-chon capsule without antibiotics combination in URI and AD group prescription of 86.30 and 88.89, respectively. Based on the study results, it found the dose regimen problem that the dose is lower than recommended in national drug list as well as the drug was also used in either contraindication or drug interaction risk. Thus the review and seminar in Fah-ta-lai-chon regimen to physician team were required to inform and update the regimen guideline following National drug list of Thai Herbal Medicine. Furthermore, IT application for notification in dosage regimen, drug interaction alert and also labelling alert would be developed in further.