Doctors at the Osmania General Hospital in Hyderabad have been over-prescribing corticosteroids and ranitidine, according to a report published in the World Health Organisation’s Essential Drugs Monitor (EDM).

The latest issue of EDM, which was distributed globally on Saturday through dozens of e-mail networks, said this was revealed in a four-year study conducted by researchers at the Clinical Pharmacology Department.

Drs G B Simpson and D Govinda Das examined the amount of medication, which indoor patients at the hospitals received during the study period and found that in the first year (2000-2001) the daily prescription rate of various corticosteroids was 508.42 doses per 1000 patients. This went up to 536.81 doses per 1000 patients during the next year. Statistically speaking, this means that every alternate patient was receiving one drug or another from the corticosteroids group.

A similar study carried out in Serbia during the crisis-ridden years of 1997 and 1998 showed that in that country, doctors had prescribed just 325.00 daily doses of steroids per 1000 patients in 1997 and 320.70 daily doses in 1998.

“Two categories of toxic effects result from the therapeutic use of cortico-steroids, those resulting from withdrawal of steroid therapy and those resulting from continued use of supraphysiological doses. The side effects from both of these categories are potentially life threatening and a careful assessment of the risks and benefits in each patient is essential,” the report observes.

Ranitidine use was 380.42 daily doses per 1000 patients during 2000.2001 increasing to 488.92 daily doses per 1000 patients during 2001.2002. At Osmania, ranitidine is prescribed as prophylaxis against Non Steroidal Anti-Inflammatory Drugs (NSAIDs) induced ulcers, and treatment of peptic ulcer, gastroesophageal reflux disease, and non-ulcer dyspepsia. Prophylactic use of ranitidine is not needed with short-term NSAIDs therapy in patients without any history of ulcer disease.

Now a special programme is underway to educate the doctors in Osmania General Hospital about the proper therapeutic uses of these drugs, the study concludes.