Study of prescribing pattern of antimicrobials in a tertiary care hospital

Abstract

Background: Antimicrobials are routinely prescribed in several disease conditions in which infections are established or suspected to be the reason for the illness. Excessive and irrational use of antimicrobials leads to development of drug resistance in microorganisms, besides increasing health-care expenditure. Antimicrobial resistance (AMR) leads to increase in morbidity and mortality. The rational use of antimicrobials is a major health need in all countries. Hence, assessment of prescribing pattern of antimicrobials is essential for clinical, educational, and economic purposes. Aims and Objectives: The objectives of the study were to evaluate and compare the prescribing pattern of antimicrobials by assessing – (i) commonly used antimicrobials; and (ii) disease conditions for which they were prescribed. Materials and Methods: It was a prospective observational study done for a period of 1 month. All the prescriptions in which antimicrobials were prescribed in the outpatient departments (OPD) and in-patient wards (IP) were included in the study. Prescriptions were analyzed for demographic and antibiotic data. Results: 1092 prescriptions were collected and analyzed. Among them, 690 prescriptions were from OPD and 382 prescriptions from in patient wards. Out patient data: Cefixime (21.30%) was commonly prescribed followed by fixed dose combination of Amoxicillin + Clavulanic acid (14.64%) and Ciprofloxacin (8.84%). Cefixime was commonly prescribed for URTI (13.43%). Oral route (82.17%) was the preferred route of administration. IP data: Cefotaxime (26.45%) was commonly prescribed followed by fixed dose combination of Piperacillin + Tazobactum (15.29%) and Ceftriaxone (14.46%). Cefotaxime was commonly prescribed preoperatively for most of the surgeries (76.56%). Intravenous route (46.86%) was the preferred route of administration. Single antimicrobial therapy (81.41%) was preferred followed by double (17.80%) and triple (0.79%) antimicrobial therapy. Conclusion: Cefixime and cefotaxime were commonly used in OPD and in patient wards, respectively. Oral route and intravenous route were the preferred route in OPD and IP wards, respectively. Single antimicrobial therapy was commonly preferred in both IP and out-patient wards. Although double and triple antimicrobial therapy was prescribed in small number of patients, it should be cautiously used to prevent AMR.