Abstract
Introduction: This study was done to understand the purpose of using higher grade antimicrobials in a one year period and to compare the consumption of commonly prescribed parenteral antimicrobial agents in four consecutive years in a tertiary care hospital of Nepal.
 Materials & Methods: A retrospective observational study was carried out to collect the information on prescription of selected six classes of antimicrobial for all admitted patients aged 2 years or above for a one-year period. Further, the antimicrobial consumption tool 2016 was used to calculate defined daily dose (DDD) per 100 bed days of commonly dispensed parenteral antimicrobials for four consecutive years.
 Results: A total of 2568 antimicrobial supply forms prescribing higher grades antimicrobials were analyzed. The indications for use of antimicrobials were mainly for empiric treatment. Among the infections being treated, lower respiratory tract infection (LRTI) was the most frequent cause. Piperacillin-tazobactam was most frequently prescribed followed by Meropenem. Also, DDD for commonly used parenteral antimicrobials showed increasing trends over four consecutive years.
 Conclusion: The prescription of higher grades of antimicrobial for empiric treatment and surgical prophylaxis need to be monitored. The rate of consumption of such antimicrobials could not be assessed due to lack of similar studies but the increase in DDD/100 bed days each year suggested the rise in consumption of antimicrobial in the same institution.
Highlights
This study was done to understand the purpose of using higher grade antimicrobials in a one year period and to compare the consumption of commonly prescribed parenteral antimicrobial agents in four consecutive years in a tertiary care hospital of Nepal
Collecting data on motives for antibiotic use is the first step in managing the problem of antibiotic resistance as such information is necessary for a constructive approach to problems that arise from the multiple antibiotics prescription[3,4,5,6]
Selected higher grades antimicrobials (Carbapenem, Aminoglycosides, Glycopeptides, Tigecycline, Beta lactam in combination with beta lactamase inhibitors, Polymyxins) were included in the study as restricted antimicrobial forms need to be filled by the medical officer if the primary consultant decides to prescribe those antibiotics on the basis of local antimicrobial guidelines and send that form to pharmacy to get the supply The antibiotics would be supplied through the form for a maximum of seven days and if days of therapy needed to be extended, justification for such use was to be provided in the form and approval from the antimicrobial committee was a must who decide if the request was compliant with our guidelines
Summary
This study was done to understand the purpose of using higher grade antimicrobials in a one year period and to compare the consumption of commonly prescribed parenteral antimicrobial agents in four consecutive years in a tertiary care hospital of Nepal. The Anatomical Therapeutic Chemical (ATC) classification system and the Defined Daily Dose (DDD) as a measuring unit have become the gold standard for international drug utilization research[7,8]. Few studies have been carried out in western and eastern regions of Nepal 9,10,11,12 with regard to drug utilization in hospitals, whereas such information from central Nepal, from a tertiary referral center is lacking. The main objective of this study was to understand the prescribing patterns of higher grade antimicrobials and to measure the consumption of antimicrobial agents in the same hospital for four consecutive years
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
