Variations in antibiotic use across India: multi-centre study through Global Point Prevalence survey

Singh, Sanjeev; Sengupta, Shamik; Antony, Reena; Bhattacharya, Sanjay; Mukhopadhyay, Chiranjay; Ramasubramanian, V; Sharma, Anita; Sahu, Suneeta; Nirkhiwale, S.; Gupta, Shweta; Rohit, Anusha; Sharma, Suraj; Raghavan, V.; Barman, Purabi; Sood, Seema; Mamtora, Dhruv; Rengaswamy, S.; Arora, Anita; Goossens, Herman; Versporten, Ann

doi:10.1016/j.jhin.2019.05.014

Cited by 53 publications

(79 citation statements)

References 8 publications

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“…On reviewing empirical antimicrobial therapies with CAI, the two most common antimicrobials were third generation cephalosporins (26.2%) ( Table 3) which is similar to two other Indian studies 7,11 . The similar wide use of cephalosporins was reported in Turkey, Jordan, Brazil, Nigeria and Saudi.…”

Section: Discussionsupporting

confidence: 72%

A Point Prevalence Survey Of Antimicrobial Prescribing In A South Indian Tertiary Hospital; Using Global PPS Tool

Chadalavada

Babu²,

Balamurugan

2021

Asian Journal of Pharmaceutical Research and Health Care

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Identifying the targets for improving antimicrobial prescription and development of antimicrobial stewardship interventions can better serve to combat the situation of antimicrobial resistance. The primary objective was to determine the prevalence of antimicrobial use at tertiary care teaching hospital with both acute and long-term care patients. A periodical point prevalence survey was done in a tertiary care hospital of South India during 2019 using manual and webbased GLOBAL-PPS tool. Of 945 patients eligible for the study, 645 (69.5 %) received at least one antibiotic, with highest rates in the adult surgical ward and pediatrics. Of 645 therapeutic antibiotic prescriptions, 58.6% prescriptions have an infectious indication of them, 62.6% are community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. The prevalence of antibiotic use is very high, and our study evidence that the country needs a robust antimicrobial stewardship intervention program.

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Section: Discussionsupporting

confidence: 72%

A Point Prevalence Survey Of Antimicrobial Prescribing In A South Indian Tertiary Hospital; Using Global PPS Tool

Chadalavada

Babu²,

Balamurugan

2021

Asian Journal of Pharmaceutical Research and Health Care

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“…Consistent with other surveys in Asia 18,19 and globally 13 , the predominant reason for antibiotic prescription in Jakarta hospitals were lower respiratory tract infections. In our survey, the mostly used antibiotic classes were third-generation cephalosporines (mainly ceftriaxone), fluoroquinolones (mainly levofloxacin), and carbapenems (mainly meropenem), all predominantly used for pneumonia, among several other diagnosis.…”

Section: Discussionsupporting

confidence: 88%

A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals

Limato¹,

Nelwan²,

Mudia³

et al. 2021

Preprint

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Background Antibiotic misuse and overuse are a major driver of antimicrobial resistance, but systematic data in Indonesia are scarce. Objectives To evaluate patterns and quality indicators of antibiotic prescribing in six acute-care hospitals in Jakarta, Indonesia. Methods We conducted a hospital-wide point prevalence survey (PPS) between March and August 2019, using Global-PPS and WHO-PPS protocols. The analysis focused on antibacterials for systemic use (antibiotics). Results Of 1602 inpatients, 993 (62.0%) received ≥1 antimicrobials. Of 1666 antimicrobial prescriptions, 1273 (76.4%) were antibiotics. Most common reasons for prescribing were pneumonia (27.7%), skin and soft tissue infections (8.3%), gastrointestinal prophylaxis (7.9%), and gastrointestinal infections (5.4%). The most common indication was community-acquired infection (42.6%), followed by surgical prophylaxis (22.6%), hospital-acquired infection (18.5%), medical prophylaxis (9.6%), unknown (4.6%) and other indications (2.1%). The most prescribed antibiotic classes were third-generation cephalosporins (44.3%), fluoroquinolones (13.5%), carbapenems (7.4%), penicillins with B-lactamase inhibitor (6.8%) and aminoglycosides (6.0%). According to the WHO AWaRe classification, Watch antibiotics accounted for 67.4%, followed by 28.0% Access, 2.4% Reserve, and 2.2% Unclassified. Reason for prescribing, stop/review date and planned duration were poorly documented. Hospital antibiotic guidelines were not available for 28.1% of prescriptions, and guideline compliance was 52.2% (478/915). Parenteral administration was high (85.1%). Targeted (non-empirical) prescriptions comprised 8.1% (44/542) for community-acquired infections and 26.8% (63/235) for hospital-acquired infections. Conclusions Our data indicate a high rate of parenteral, empiric use of broad-spectrum antibiotics in Indonesian hospitals, coupled with poor documentation and guideline adherence. The findings suggest important areas for antimicrobial stewardship interventions.

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“…In a study by Singh et al, antibiotics were most commonly used in respiratory tract, skin and soft tissue, central nervous system followed by intra-abdominal infections. 25 The prescription of almost an average of three antibiotics per patient in all inpatient departments indicates need for changes in antibiotic prescription and utilization. The prescription of newer antibiotics and broad-spectrum antibiotics shows changing pattern of bacterial susceptibility.…”

Section: Disscusionmentioning

confidence: 99%

Antibiotic prescription analysis of inpatients in a tertiary care teaching hospital

Srinivasa

Rajendran

2020

Int J Basic Clin Pharmacol

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Background: Antibiotics are one among the commonly prescribed drugs. Patterns of antibiotic resistance widely follows local patterns of antibiotic prescribing and usage. Periodic surveillance of antibiotic prescriptions at regional level are essential to understand and combat antimicrobial resistance. To study the prescribing pattern of antibiotics among inpatients of various specialties in a tertiary care teaching hospital. Method: A prospective observational study of prescribing pattern of antibiotics was conducted among inpatients of various specialties in a tertiary care teaching hospital. Antibiotic prescribing data was collected using a semi structured proforma. The data obtained was analyzed and the conclusions were drawn using descriptive analysis.Results: A total of 1161 prescriptions were collected. 3211 antibiotics were prescribed. Mean average duration of treatment with antibiotics per patient was 11.8 days. Use of 3rd generation cephalosporins, imipenem, piperacillin and vancomycin observed. 75% of antibiotics were prescribed for prophylactic use. Antibiotics prescribed for therapeutic indication were supported by clinical, radiological and other investigations like culture and sensitivity reports.Conclusions: The present study highlights the use of antibiotics for long duration among admitted patients. Implementation of antimicrobial stewardship program with adherence to standard treatment guidelines is essential to combat antimicrobial resistance.

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Variations in antibiotic use across India: multi-centre study through Global Point Prevalence survey

Abstract: Empirical antimicrobial therapy Targeted antimicrobial therapy usage, underlining the need for antibiotic stewardship to promote evidence-based practice.

Cited by 53 publications

References 8 publications

A Point Prevalence Survey Of Antimicrobial Prescribing In A South Indian Tertiary Hospital; Using Global PPS Tool

A Point Prevalence Survey Of Antimicrobial Prescribing In A South Indian Tertiary Hospital; Using Global PPS Tool

A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals

Antibiotic prescription analysis of inpatients in a tertiary care teaching hospital

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