Evaluation of antibiotic consumption and compliance to hospital antibiotic policy in the surgery, orthopedics and gynecology wards of a tertiary care hospital

Abstract

To evaluate antibiotic consumption and compliance to hospital antibiotic policy in the surgery, orthopedics and gynecology wards of a tertiary care hospital. Methods: A prospective observational study was conducted over eight months on adult inpatients prescribed with antibiotics. Data were collected using a predesigned antibiotic form and evaluated using Defined Daily Dose per 100 bed-days. Antibiotics prescribed were classified using World Health Organization Access, Watch and Reserve classification (WHO AWaRe) and assessed for compliance to the hospital antibiotic policy which is in accordance with the National Treatment Guidelines for Antimicrobial use in Infectious Diseases (version 1.0.2016). Results: Out of 2653 patients enrolled, 44.3% were males and 55.7% were females. The antibiotic usage rate was 29%. Cephalosporins were the most frequently prescribed class of antibiotics. The top three antibiotics prescribed were cefuroxime, metronidazole, and ceftriaxone. Classification of antibiotics using WHO AWaRe policy showed that 36% of antibiotics were prescribed from the Access group and 53% from the Watch group. The use of antibiotic combinations from the not recommended group of AWaRe was also observed. Total compliance observed towards the hospital's antibiotic policy was 77.7%. The most common reason for non-compliance to hospital policy was inappropriate duration of antibiotic therapy. Conclusions: The use of watch group of antibiotics over access group due to concerns of antimicrobial resistance shows the need for local adaptation of WHO AWaRe classification. Despite good adherence to the hospital's antibiotic policy, extended duration of antibiotic therapy requires special attention. Further optimization of antibiotic use can be achieved by timely revision and implementation of hospital antibiotic policy.

Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia

“…Literature has shown that prescribers which adhere to the AWaRe protocol have reported a reduction in AMR cases in their healthcare facilities [24] [25]. However, most prescribers do not adhere to the AWaRe protocol, thereby worsening the number of microorganisms developing resistance to antibiotics [26] [27]. Conversely, in Ghana, prescribers adhered to the AWaRe classification protocol, indicating good AMS [28].…”

“…The AWaRe protocol also guides prescribers to ensure that they prescribe more than 60% of Access group antibiotics compared to the other groups [33]. However, evidence has shown an overprescribing of Watch group antibiotics compared to Access antibiotics [27] [30] [33] [34].…”

Khảo Sát Việc Sử Dụng Kháng Sinh Dự Phòng Trong Phẫu Thuật Chấn Thương Chỉnh Hình Tại Bệnh Viện Đa Khoa Tâm Anh Tp. Hồ Chí Minh

“…Hầu Tỷ lệ tuân thủ chung của nghiên cứu là 78,1%. Khi so sánh với nghiên cứu về việc sử dụng KSDP trong phẫu thuật chấn thương chỉnh hình khác, nghiên cứu của chúng tôi có tỷ lệ tuân thủ chung thấp hơn nghiên cứu của Thomas (2022) (86,3%) [8].…”

Antibiotic Prescribing Patterns in adult patients according to the WHO AWaRe Classification: A multi-facility cross-sectional study in primary healthcare hospitals in Zambia

“…Literature has shown that prescribers that adhere to the AWaRe protocol have reported a reduction in AMR cases in their healthcare facilities [22,23]. However, most prescribers do not adhere to the AWaRe protocol, thereby worsening the number of microorganisms developing resistance to antibiotics [24,25]. Conversely, in Ghana, prescribers adhered to the AWaRe classi cation protocol, indicating good AMS [26].…”

“…The AWaRe protocol also guides prescribers to ensure they prescribe more than 60% of Access group antibiotics compared to the other groups [31]. However, evidence has shown an overprescribing of Watch group antibiotics compared to Access antibiotics [25,28,31,32].…”