Antibiotic resistance poses a significant threat to the world, and irrational use of antibiotics is a major contributing factor. Evaluation of antimicrobial use is underway with the help of indicators and the World Health Organization (WHO) classification of antibiotics into Access, Watch, and Reserve (AWaRe) categories. We aimed to evaluate the prescribing pattern of antibiotics using the AWaRe classification by the WHO and selected indicators for antimicrobial use in hospitals. A total of 1.000 prescriptions were analyzed during the study for antibiotic prescribing patterns. Antibiotic consumption was calculated using defined daily dose (DDD) methodology. The prescribing pattern was evaluated using the WHO classification of antibiotics into the categories AWaRe and using selected indicators (hospital and prescribing) for antimicrobial use in hospitals. A total of 1.128 antibiotics were prescribed during the study. The 19-44 age group was prescribed a high number of antibiotics (n=510). Females were prescribed a high number of antibiotics compared with males (n=602). Azithromycin was the most commonly consumed antibiotic (14.97 DDD/1000/day). Four antibiotics from the Access category and five from the Watch category were prescribed in the study. The Watch category of antibiotics were consumed in a high number. There were no standard treatment guidelines in the hospital. In all, 98.0% of antibiotics were consistent with the hospital formulary and prescribed under generic names. The average number of antibiotics prescribed per patient was 1.12. The average duration of antimicrobial treatment was 5.24 days. The percentage of patients prescribed antimicrobials for pneumonia in accordance with treatment guidelines was 13.28%. Irrational use of antibiotics exists in hospitals. There is a need to maintain standard treatment guidelines in the hospital because it prevents irrational use of antibiotics.

Integrating a Pharmacovigilance and Response Unit Team for a Better Adverse Drug Reaction Reporting and Management: Insights from a Prospective Cross-Sectional Study - Turkish Journal of Pharmaceutical Sciences

The aim of the present study was to evaluate the effectiveness of oral nano formulation of vitamin-D in pain management of some neurospinal and musculoskeletal disorders. The study was conducted for duration of two years on patients suffering from neurospinal disorders like generalised back pain, myofascial syndrome, osteopenia and osteoporosis. Numerical Rating scale was used to assess pain scores before and after treatment. The dose of vitamin-D formulation was 60, 000IU weekly for six weeks. Non-parametric tests were employed for qualitative data and quantitative data (with non-Gaussian distribution) to find out statistically significant relation between the variables. Vitamin-D levels and pain scores within the group were compared using Wilcoxon test. pvalue<0.05 was considered as statistically significant. p-value<0.01 was considered as statistically highly significant. There was a very highly statistically significant association between vitamin-D formulation and improvement in vitamin-D levels (p<0.0001) and pain scores (p<0.0001). Our study concludes that oral nano formulation of vitamin-D if given at 60, 000 IU weekly for six weeks was effective in treating pain due to some musculoskeletal and neurospinal disorders.

Adverse drug reactions (ADRs) remain a major, yet largely preventable, global public health challenge, causing significant morbidity, mortality, and healthcare costs. This review synthesises evidence on the global burden, pharmacovigilance systems, and prevention strategies for ADRs, integrating data from multiple regions, healthcare settings, and drug classes. Epidemiological findings reveal wide variability in incidence and mortality, with older adults, low-resource settings, and exposure to high-risk medicines—such as antibiotics, antiretrovirals, and cardiovascular agents—representing key vulnerabilities. Despite advances in surveillance, underreporting, data quality issues, and methodological biases persist, particularly in low- and middle-income countries. Comparative analyses of pharmacovigilance platforms, including World Health Organization’s (WHO’s) VigiBase, EudraVigilance, and EU-ADR, highlight complementary strengths and the value of integrating spontaneous reporting with electronic health record analytics. Emerging statistical methods, including machine learning and federated analytics, offer improved signal detection timeliness and precision. Prevention strategies span prescriber-level, system-level, and patient engagement interventions. These include clinical decision support systems, pharmacogenomic-guided therapy, deprescribing protocols, mobile reporting applications, and wearable biosensors. Evidence shows that active surveillance and automated alerts outperform voluntary reporting, while digital tools can enhance detection and risk communication. However, implementation remains uneven due to infrastructure, workforce, and policy gaps. Looking forward, achieving the World Health Organization’s goal of halving severe medication-related harm by 2030 will require embedding ADR surveillance and prevention into universal health coverage frameworks. Policy priorities include mandating interoperable safety systems, harmonising international safety indicators, investing in capacity building for resource-limited settings, and aligning incentives with safer prescribing. Coordinated global action can bridge surveillance gaps, strengthen prevention, and build resilient, equitable pharmacovigilance systems, advancing both patient safety and sustainable health systems worldwide.

To evaluate potentially inappropriate medications, potential drug-drug interactions, and prescribing practices in elderly ambulatory patients. We carried out a cross-sectional study on 275 elderly patients attending different outpatient departments. We used the Screening Tool for Older Person's Prescriptions criteria version two to identify potentially inappropriate medications, IBM Micromedex, to categorize potential drug-drug interactions as major and moderate. World Health Organization prescribing indicators were used to evaluate prescribing practices. The prevalence of potentially inappropriate medications in 275 prescriptions was 21.9%. Diclofenac was the most common inappropriate drug (n=23). Metoprolol is the second most inappropriate drug (n=12). Amlodipine and clopidogrel, aspirin and furosemide, and aspirin and spironolactone together accounted for 71.42% of major interactions (n=15). Atorvastatin and clopidogrel was the most common moderate drug-drug interaction in our study (n=24). The average number of drugs per encounter, the percentage of drugs with a generic name, and the percentage of drugs from the essential drugs list must be improved. There is a need to provide awareness through education about the explicit criteria to identify potentially inappropriate medications and prescribing indicators that aid in rational prescribing in the elderly.

Prospective Drug Utilization Evaluation Analysis in Outpatient Departments with Ear, Nose, and Throat Outpatients: Incorporating Benchmarks and World Health Organization Indicators - Turkish Journal of Pharmaceutical Sciences