Abstract
Background : In 2019, WHO has developed ‘AWaRe’ (Access, Watch, Reserve) classification to enhance the quality of antibiotic use in hospitals and to combat antimicrobial resistance. The current study evaluated usage of antimicrobial pattern in the surgical wards of a tertiary care hospital based on the AWaRe classification. Materials and Methods : We have retrospectively collected prescriptions from the hospital medical records of surgery ward for 6 months duration (January-June 2023). All prescriptions were analyzed for antimicrobial precribing pattern using WHO AWaRe classification. To quantify antimicrobial use, Defined Daily Dose (DDD) and DDD/100 bed days were calculated. Results : Out of 1209 admitted patients, 1124 (92.9%) received antibiotics. The mean age of patients was 34±16.9 years. The majority of antimicrobials were prescribed to male patients (71.8%) and in patients aged 45-63 years (39.2%). A total of 15 antibiotic agents were used in the study, including 4 from access group, 10 from the watch group and one from reserve group. A total of 60.8% antimicrobials from the Watch group and 36.9%from the Access group were prescribed. Ceftriaxone (26.4% and Metronidazole (24.1%), were the most frequently prescribed antimicrobials. The overall systemic doses of Piperacillin and Metronidazole used in surgery ward were 6.6 and 7.3g DDD/100 bed-days, respectively. The average number of drugs prescribed per prescription was 5.3, and only 49.1% of antibiotics was prescribed according to generic name. Injectable antibiotics accounted for 76.7% of prescriptions, and 96.8% were prescribed from the Essential Drug List. Conclusion: The prescribing indicators in this study surpassed the WHO standard values with the most antibiotics being prescribed from the watch group in the AWaRe classification rather than the Access group. Insufficient use of generic drugs and polypharmacy contributed to antimicrobial resistance. To reduce the use of Watch group antibiotics, strict standard treatment guidelines should be implemented in hospitals. Further more, motivating health care professionals to prescribe more Access group antibiotics by their generic names could support rational prescribing and aids to minimise antimicrobial resistance. Keywords: AWaRe classification; Antimicrobial resistance, Access, Watch, Reserve
Published Version
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