Evaluation of Restricted Antimicrobial Utilization in a Tertiary Care Hospital

Abstract

The World Health Organization has declared that antimicrobial resistance is one of the top ten public health threats faced by humanity. In addition to death and disability, prolonged illness results in longer hospital stays, more expensive medicines and financial challenges for those impacted. The emergence of antimicrobial resistance was mainly attributed to the inappropriate prescribing and overuse of antimicrobials including self-medication. The main objective of our study was to study the prescribing patterns of restricted antimicrobials among in-patients in a tertiary care hospital. A prospective observational study was conducted among 108 in-patients and the rationality of prescriptions with restricted antimicrobials was analyzed. There were 174 antimicrobials prescribed in 108 patients, out of 174 antimicrobials prescribed 140 drugs were restricted antimicrobials and 34 drugs were non-restricted antimicrobials. Among restricted antimicrobials prescribed 53(49.07%) were Penicillin and Beta-lactamase inhibitors, 40(37.03%) were Carbapenems, 30 (21.42%) were third-generation Cephalosporins, 7(6.48%) were Oxazolidinones,7(6.48%) were glycopeptide antibiotic and 2(1.85%) Vancomycin. Out of 108 patients, 16(14.81%) patients were prescribed antimicrobials for prophylactic use, 63(58.33%) patients were prescribed with antimicrobials based on empirical therapy and 29(26.85%) patients were prescribed antimicrobials based on culture and sensitivity reports. The study concluded that the restricted antimicrobials were mostly prescribed based on empirical therapy (58.33%) in the study population which shows the need to control the use of restricted antimicrobials.