A prospective study on the pattern of antibiotic use in a tertiary care hospital

Abstract

Background: Indiscriminate use of antimicrobials is rampant throughout India, and this is a matter of serious concern. There are several reports linking antibiotic usage to bacterial resistance. Towards addressing this problem, community wise surveillance needs to be undertaken to monitor antibiotic exposure including their misuse. This study was meant to assess the extent and pattern of antibiotic use in a tertiary care facility. Methods: Subjects for study were patients attending a suburban hospital in central Kerala. Case records of patients who were prescribed systemic antibiotics were perused for relevant data. Seriously ill patients were excluded from the study. Results: 610 encounters with antibiotics could be identified from a total of around 2000 patient records, indicating an encounter rate of 29%; which is quite acceptable as per the WHO standard of prescribing indicators. However, more than 70% of prescriptions carried only brand names of medications. Use of antibiotics was mostly on the basis of clinical symptoms (presumptive), and culture reports were not given due credence. Prescriptions were invariably therapeutic in nature, and the concepts of surgical prophylaxis conveniently given a go by. The most common infections were those of the Upper Respiratory Tract (URTI), followed by skin and soft tissue infections. Ampicillin, azithromycin and cefuroxime were the most frequently prescribed agents. More than one third of infections were treated with a combination of antimicrobials. A general temptation for using cephalosporin -betalactamase inhibitor combinations could be related to the aggressive promotional policies of the pharmaceutical industry. Conclusions: The overall antibiotic encounter rate is acceptable as per WHO standards. But the tendency for using injections as well as antibiotic combinations is very high. Prophylactic use of antibiotics in surgical procedures is not being followed at all. A serious attempt needs to be made to implement National Guidelines for use of antimicrobials.

A study on drug usage pattern of antibiotics in patients with skin disorders

“…This is lower than the WHO standard value (100%). Moreover our values are lower comparing with the various other Indian studies conducted by Priyadharshini et al, 35 (62.5%) Mani et al, 37 (69%) and Pradeep kumar et al, 36 (91.48%). The Essential Medicine List (EML) or Essential Drug List is intended to satisfy the major health care needs of the majority of the population.…”

“…Moreover, the value was also higher compared to the findings from one of the South Indian studies by Priyadharshini et al, 35 (2.5) and also lesser than that of study conducted by Pradeep kumar et al, 36 (3.53). The percentage of encounters with antibiotics is 4.50% which lies within WHO standard value (normal range <30%), but lower when compared with studies of Priyadharshini et al, 35 (17.5%), Mani et al, 37 (29%) and Pradeep kumar et al, 36 (50.0%). The percentage of encounters with injection is 12% which is within the range of WHO value (<20%) but lower than the study conducted by Mani et al, 37 (48%).…”

“…The percentage of encounters with antibiotics is 4.50% which lies within WHO standard value (normal range <30%), but lower when compared with studies of Priyadharshini et al, 35 (17.5%), Mani et al, 37 (29%) and Pradeep kumar et al, 36 (50.0%). The percentage of encounters with injection is 12% which is within the range of WHO value (<20%) but lower than the study conducted by Mani et al, 37 (48%). The percentage of drugs from the essential medicine list in our present study is 43%.…”

Antibiotic-prescribing pattern in the outpatient departments using the WHO prescribing indicators and AWaRe assessment tool in a tertiary-care hospital in South India

“…A study conducted in a hospital in southern India revealed that 69% of drugs were from the essential drug list. [ 25 ] The prescriptions had no injection prescribed since the prescriptions were collected from a pharmacy dispensing outpatient department prescriptions.…”