Abstract
Background: Antibiotic resistance is exponentially increasing worldwide. Irrational prescription of antibiotic treatment contributes to the development of antibiotic resistance. Appropriate antibiotic use is vital in reducing the mortality caused by bacterial infections. Third generation cephalosporins are now considered as the backbone of antibiotic therapy for treatment of serious infections including those in hospitalized patients. These drugs are the commonly prescribed ꞵ-lactam antibiotics even before culture sensitivity reports arrive. Generation of resistance has been a growing concern for all clinicians and must be avoided at all costs. This drug utilization study was undertaken to understand the growing resistance acquired by the organisms against cephalosporins caused due to the superfluous and unrestrained use of cephalosporins in the medical wards of our institution.
 Objective: The study objectives were to assess:
 
 The cephalosporins generation which was most commonly prescribed
 The relevance of cephalosporins generations used in various diseases
 The shift or addition of other antimicrobials upon failure of cephalosporins treatment
 
 Methods: This was an observational study done amongst 350 patients admitted in infection wards of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of one year between January 2019 to December 2019 after obtaining institutional ethical clearance. Data was analyzed and values were presented descriptively in number and percentage form.
 Results: Maximum usage of third generation cephalosporin was seen with ceftriaxone being the most commonly prescribed third generation cephalosporin in parenteral form (59.43%). Gender analysis revealed that males (60.28%) were prescribed more cephalosporins as compared to females (39.71%), whereas, frequent usage was seen in the age group 61 – 70 years. Bacteriological investigations were done in only 103 (29.42%) cases following which shift or addition of other antimicrobials was seen in 13 (3.71%) cases. Metronidazole was the most frequently co-prescribed with cephalosporins.
 Conclusion: Our study revealed extensive usage of third generation cephalosporin and the treatment regimens implemented in majority of the cases were without prior culture sensitivity test leading to irrational prescribing. Our study, along with the various other studies, would help in taking the corrective measures to curb the unnecessary use of antibiotics, and framing the guidelines for the doctors prescribing them.
Highlights
Increasing morbidity and mortality owing to the infectious diseases, in spite of the availability of lifesaving antibiotics, is an alarming worldwide situation of the utmost importance
Our study revealed extensive usage of third generation cephalosporin and the treatment regimens implemented in majority of the cases were without prior culture sensitivity test leading to irrational prescribing
Male preponderance was observed which may be due to the increased exposure of males to the environmental triggers and accidents, which may be the cause of various bacterial infections
Summary
Increasing morbidity and mortality owing to the infectious diseases, in spite of the availability of lifesaving antibiotics, is an alarming worldwide situation of the utmost importance. Third generation cephalosporins are considered as the backbone of antibiotic therapy for treatment of serious infections including those in hospitalized patients. These drugs are the commonly prescribed ꞵ-lactam antibiotics even before culture sensitivity reports arrive. Generation of resistance has been a growing concern for all clinicians and must be avoided at all costs This drug utilization study was undertaken to understand the growing resistance acquired by the organisms against cephalosporins caused due to the superfluous and unrestrained use of cephalosporins in the medical wards of our institution. Along with the various other studies, would help in taking the corrective measures to curb the unnecessary use of antibiotics, and framing the guidelines for the doctors prescribing them
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