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.
Highlights
The worldwide increase in antibiotic resistant bacteria is of great concern
Antibiotic prescribing during hospital stay was common in both hospitals, and significantly higher in the Teaching hospital (TH) (82%) compared with the Non-teaching hospital (NTH) (79%, p = 0.003)
The highest percentage of patients prescribed antibiotics in the NTH were of 0–4 years of age
Summary
The 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 Nonteaching, in Ujjain, India. Antibiotics are widely used medicines to treat both life threatening and trivial infections. Their indiscriminate use increases the risk of bacterial drug resistance [1, 2]. The public sector, regulated by state government, provides medical care either free or with nominal charges, and is obliged to follow national prescribing guidelines. In India, studies on the use of antibiotics have mainly been conducted in public sector facilities, rather than private settings [13,14,15,16] where prescribing guidelines are often not implemented [17]
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