Outpatient antibiotic prescription rate and pattern in the private sector in India: Evidence from medical audit data

Abstract

The key objective of this research was to generate new evidence on outpatient antibiotic prescription rate and patterns in the private sector in India. We used 12-month period (May 2013 to April 2014) medical audit dataset from IQVIA (formerly IMS Health). We coded the diagnosis provided in the medical audit data to International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the prescribed antibiotics for the diagnosis to Anatomic Therapeutic Chemical (ATC) classification of World Health Organization (ATC index-2016). We calculated and reported antibiotic prescription rate per 1,000 persons per year, by age groups, antibiotic class and disease conditions. Our main findings are—approximately 519 million antibiotic prescriptions were dispensed in the private sector, which translates into 412 prescriptions per 1,000 persons per year. Majority of the antibiotic prescriptions were dispensed for acute upper respiratory infections (J06) (20.4%); unspecified acute lower respiratory infection (J22) (12.8%); disorders of urinary system (N39) (6.0%); cough (R05) (4.7%); and acute nasopharyngitis (J00) (4.6%) and highest antibiotic prescription rates were observed in the age group 0–4 years. To conclude our study reports first ever country level estimates of antibiotic prescription by antibiotic classes, age groups, and ICD-10 mapped disease conditions.