Antimicrobial drugs usage in a tertiary care hospital –A descriptive study

Background: Emergence of resistant organisms is alarmingly high all over the world. Irrational and inappropriate prescription of antimicrobials is the major contributing factor for developing drug resistance in addition to poor patient compliance. It is the high time to create awareness of antimicrobial resistance among physicians and patients. Encouraging physicians/surgeons to undergo training programmes on infectious disease control periodically would be beneficial to combat the resistant organisms, so called super bugs.

Objectives: To assess the pattern of antimicrobial usage in a tertiary care hospital, to determine whether antimicrobials are prescribed judiciously.

Methods: A retrospective study was conducted to determine the current antimicrobial prescribing practices at Tagore Medical College Hospital. A randomised sample of 100 inpatient case sheets of General Medicine, OBG, General Surgery, Paediatrics, Chest Medicine, Skin, and ENT from Medical Records Department was analysed with respect to oral and parenteral (iv) administration of antimicrobials.

Results: In this study, 53% were males and 47% were females. Majority of patients were middle aged (17-60yrs). A total of 16 antimicrobials were prescribed for 100 inpatients. The most frequently used were Metronidazole and Ciprofloxacin. Duration of treatment was minimum 3 days, maximum of 13 days and mean duration was 5.5 days. The common route by which antimicrobials were administered was Parenteral as the patients were inpatients. The Parenteral (iv) drugs were Metronidazole (52%), Ciprofloxacin (42%), Cefotaxime (27%), Amikacin (7%), Ceftriaxone (7%). Among 100 prescriptions, 63% were empirical prescriptions, 12% were directed and 25% were targeted prescriptions.

Conclusions: The most frequently used antimicrobials were Metronidazole and Ciprofloxacin and the condition for which the antimicrobials were commonly used was acute gastroenteritis. The proportion of targeted prescriptions was low compared to empirical prescriptions. Antimicrobials have to be prescribed rationally based on antibiotic policy.

Antimicrobial agents, Drug Resistance, Rational Prescription

Seikh Farid Uddin Akter, et al. Antimicrobial Use And Factors Influencing Prescribing In Medical Wards Of A tertiary care hospital in Malaysia. International Journal of science, Environment And Technology, Vol. 1, No 4, 2012, 274-284

Vandana A Badar, Sanjaykumar B Navale. Study of Prescribing Pattern of Antimicrobial Agents in Medicine Intensive Care Unit of a Teaching Hospital in Central India. JAPI April 2012 Vol. 60(20-23)

Bhavesh K. Lalan, R. S. Hiray, B. B. Ghongane Drug Prescription Pattern Of Outpatients In A Tertiary Care Teaching Hospital In Maharashtra Int J Pharm Bio Sci 2012 July; 3(3): P 225 – 229

Sahar Mohy Ahmed El-Ashmony. Different Patterns of Inappropriate Antimicrobial Use: A Cross Sectional Study., Life Science Journal 2013;10(3)

Farhan ahmad Khan, Vinod Kumar Singh, SanjeeV Sharma, Preeti Singh. Prospective Study on the Antimicrobial Usage in the Medicine Department of a Tertiary Care Teaching Hospital -,JCDR.2013/6265.3125

Cheekavolu C, Pathapati RM et al.Evaluation Of Drug Utilization Patterns During Initial Treatment In The Emergency Room: A Retro Prospective Pharmacoepidemiological Study. ISRN Pharmacology 2011; 2011:261585.

Pandiamunian J, somasundaram G.A study on prescribing pattern of anti microbial agents in the medical intensive care unit of a tertiary care teaching hospital in puducherry union territory, south india. International Journal of Pharmacy and Pharmaceutical Sciences, Vol 6, Issue 3, 235-238

Shankar R.V, et al. Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study. Ann Clin Microbiol Antimicrob 2003;2:7.

Sharif S, Al-Shaqra M, Hajjar H, Shamout A, Wess L Patterns of Drug Prescribing In a Hospital in Dubai, United Arab Emirates.. Libyan J Med 2008;3:10-2

Girish MB, Kumer TN, Srinivas R. Pattern of antimicrobials used to treat infected

Diabetic in a tertiary care hospital in Kolar. International Journal of Pharmaceutical

And Biomedical Research 2010; 1: 48-52.

Cusini A,Rampini SK,Bansal V,Kuster SP,et al.Different patterns of inappropriate antimicrobial use in surgical and medical units at a tertiary care hospital in Switzerland. A prevalence study (2010).Plos one 5(11), e14011, Pg 1-8.

Pujate E, Vigante D, Vingre I, Kockina E, Pavlovska D, Mironovska A, Nikitina O,

Kula M, Zeidaka L, Lucenko I, Perevocikovs J, Dumpis U. Prevalence study of

antimicrobial use and hospital infections in Lativa 2005; 6:35-39.

Ken Harvey et al. Initiatives to improve antibiotic use.Australian prescriber (An independent review).1999;22:26-8

Hanssens Y, Ismaeili BB. Antibiotic prescription pattern in a medical intensive care unit in Qatar. Saudi Med J 2005;26:1269-76.

Shamin ara begum et al. Prescribing pattern of antimicrobials used in under five years children in cough or cold and pneumonia in outdoor settings of two tertiary level hospitals. Bangladesh journal of physiology and pharmacology 2011; 27(1&2):13-20.

Rashid HU, Chowdhury SAR, Islam N. Pattern of antibiotic use in two teaching hospitals. Tropical doctor 1986; 152–154.