Assessment of Antibiotic Prescription Pattern Using who Prescribing Indicators and Aware Categorization of Antibiotics

Abstract

Background: Medicines play a crucial role in the healthcare delivery of a hospital. The appropriate use of medicines gives us assessment of the quality of health services being provided in a particular region. Aim: To evaluate the prescribing practices and antibiotic utilization patterns so that the extent of irrational use can be assessed by comparing them with published ideal values set by WHO. Study design: Retrospective, cross-sectional study. Place and duration of study: Teaching Hospital of Faisalabad: Independent University Hospital (IUH), from Jan 2018 to June/July 2018. Methodology: 200 cases were selected through systematic random sampling from medicine/surgery wards and pharmacy registers. The standard World Health Organization prescribing indicators and AWaRe categorization of antibiotics were used to assess the prescribing practices of physicians/surgeons. Published ideal standards for each of the indicators were compared with study findings to identify extent of irrational drug use. Results: Most of the facility indicators were met with. The Drug and Therapeutic Committee (DTC) was functional. The Standard treatment guideline booklets (STGs) and Essential Drugs List (EDL) of the hospital were available. 88% of the key drugs listed in EDL were available in stock. The expenditure on antibiotics compared to total medicines was 17%. Regarding prescribing indicators: the average number of drugs prescribed per encounter was 6 (optimal value 1.6–1.8). Average no of antibiotic per prescription amounted to almost 1 (0.925). % prescriptions with an antibiotic amounted to 72% (optimal value 20-26.8%).72% antibiotics were prescribed from the EDL formulary of the hospital (optimal value 100%). Conclusion: Regarding compliance with prescribing indicators and AWaRe categorization of antibiotics by WHO, significant deviation was observed. Education and training of physicians according to WHO parameters is required to ensure rational prescribing. Keywords: Prescription pattern, WHO Prescribing Indicators, AWaRe Categorization