Antimicrobial drugs usage in a tertiary care hospital A descriptive study

Abstract

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.