Antibiotic utilization pattern in the department of surgery in a tertiary care centre in eastern India

Abstract

Background: The overuse and volume of antibiotic prescription has been found to correlate to the incidence of bacterial resistance. Clinical audit and education can favourably change antibiotic prescribing patterns among practitioners.Methods: Prospective cross-sectional prevalence survey carried out in inpatient department (IPD) and outpatient department (OPD) of department of Surgery, Rajendra Institute of Medical Sciences, Ranchi. 200 prescriptions from OPD and 200 case sheets from IPD were randomly selected. Data was analyzed as per WHO outpatient prescribing indicators. ICU patients and patients on anti-tubercular treatment, antifungals etc. were excluded from this study. Data were computed and analyzed using MS Excel.Results: In the OPD, the average no of drugs per patient was 3.445 of which 17% were injections. 33% of drugs prescribed were antibiotics. Beta-lactams followed by nitroimidazoles were the most common antibiotic class. In the IPD, an average of 2.26 antibiotics per patients was prescribed. 21% of antibiotics were prescribed by a generic name and 196 patients received antibiotic prophylaxis. β-lactams again were the most commonly prescribed antibiotic class with 42.7% (n=193) of total antibiotics prescriptions, Metronidazole (n=101, 22.37%) was the most prescribed antimicrobial agent.Conclusions: The practice of polypharmacy and high antibiotic prescription rate is a concern in our part of the country. Prescriptions writing in generic name needs to be encouraged. There is an acute need for the development of antibiotics prescribing guidelines in India.