Antibiotic prescribing in two private sector hospitals; one teaching and one non-teaching: A cross-sectional study in Ujjain, India

Abstract

BackgroundThe worldwide increase in antibiotic resistant bacteria is of great concern. One of the main causes is antibiotic use which is likely to be high but is poorly described in India. The aim was to analyze and compare antibiotic prescribing for inpatients, in two private sector tertiary care hospitals; one Teaching and one Non-teaching, in Ujjain, India.MethodsA cross-sectional study with manual data collection was carried out in 2008. Antibiotic prescribing was recorded for all inpatients throughout their hospital stay. Demographic profile of inpatients and prescribed antibiotics were compared. WHO Anatomical Therapeutic Chemical (ATC) classifications for antibiotics was used and Defined Daily Doses (DDD) were calculated per patient day.ResultsA total of 8385 inpatients were admitted during the study period. In the Teaching hospital (TH) 82% of 3004 and in the Non-teaching hospital (NTH) 79% of 5381 patients were prescribed antibiotics. The most commonly prescribed antibiotic groups were; fluoroquinolones and aminoglycosides in the TH and, 3rd generation cephalosporins and combination of antibiotics in the NTH. Of the prescriptions, 51% in the TH and 87% in the NTH (p<0.001) were for parenteral route administration. Prescribing by trade name was higher in the NTH (96%) compared with the TH (63%, p<0.001).ConclusionsThe results from both hospitals show extensive antibiotic prescribing. High use of combinations of antibiotics in the NTH might indicate pressure from pharmaceutical companies. There is a need to formulate and implement; based on local prescribing and resistance data; contextually appropriate antibiotic prescribing guidelines and a local antibiotic stewardship program.

Extensive Antibiotic Prescription Rate among Hospitalized Patients in Uganda: But With Frequent Missed-dose Days

“…Antibiotic use among hospitalized patients in Uganda hospital located in a small Indian community; and 79% (n ¼ 5381) and 82% (n ¼ 2463) among inpatients at 350 bed and 570 bed tertiary health facilities, respectively, in a large Indian community. 25,26 Although antibiotics were extensively used, our inpatients were frequently underdosed on the prescribed/dispensed antibiotics. The measured extent of antibiotic use in our setting, as quantified by DDDs per 1000 patient-days (531), was similar to Dutch hospitals (523 in 2003 and 698 in 2009), yet Dutch hospitals are known to have the lowest levels of total antibiotic consumption in Europe.…”

Study on Prescribing Pattern of Antibiotics in a Pediatric Out-Patient Department in a Tertiary Care Teaching and Non-Teaching Hospital

“…2 Their indiscriminate use increases the risk of bacterial drug resistance and thus have prompted the need to use antibiotics judiciously in paediatrics practice. 3 Many of the antibiotics are unnecessarily prescribed for viral infections such as common cold. 4 Thus using antibiotics to treat these viral infections is considered misuse/overuse of antibiotics.…”

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“…A cross sectional study was conducted to compare antibiotic prescribing for inpatients, in two private sector tertiary care hospitals in Ujjain; which also showed an inappropriate use of antibiotics. 9 Irrational drug pattern has been widely reported from both developed as well as developing countries. 10 The strategies to prevent irrational use of drug is by conducting field surveys and providing scientific evidences.…”