Antibiotic Prescribing Patterns Research Articles

Antibiotic Prescribing Patterns for Respiratory Tract Illnesses Following the Conclusion of an Education and Feedback Intervention in Primary Care.

A study previously conducted in primary care practices found that implementation of an educational session and peer comparison feedback was associated with reduced antibiotic prescribing for respiratory tract diagnoses (RTDs). Here, we assess the long-term effects of this intervention on antibiotic prescribing following cessation of feedback. RTD encounters were grouped into tiers based on antibiotic prescribing appropriateness: tier 1, almost always indicated; tier 2, possibly indicated; and tier 3, rarely indicated. A χ2 test was used to compare prescribing between 3 time periods: pre-intervention, intervention, and post-intervention (14 months following cessation of feedback). A mixed-effects multivariable logistic regression analysis was performed to assess the association between period and prescribing. We analyzed 260 900 RTD encounters from 29 practices. Antibiotic prescribing was more frequent in the post-intervention period than in the intervention period (28.9% vs 23.0%, P < .001) but remained lower than the 35.2% pre-intervention rate (P < .001). In multivariable analysis, the odds of prescribing were higher in the post-intervention period than the intervention period for tier 2 (odds ratio [OR], 1.19; 95% confidence interval [CI]: 1.10-1.30; P < .05) and tier 3 (OR, 1.20; 95% CI: 1.12-1.30) indications but was lower compared to the pre-intervention period for each tier (OR, 0.66; 95% CI: 0.59-0.73 tier 2; OR, 0.68; 95% CI: 0.61-0.75 tier 3). The intervention effects appeared to last beyond the intervention period. However, without ongoing provider feedback, there was a trend toward increased prescribing. Future studies are needed to determine optimal strategies to sustain intervention effects.

Antibiotic Resistance-An institutional questionnaire study

To determine the pattern of antibiotic prescription and to assess the knowledge of antibiotic resistance among dentists. Material and Methods An electronic version of the questionnaire regarding antibiotic use and knowledge on antibiotic resistance was created using google forms and a link was mailed to dental surgeons and their response was recorded. Data obtained was recorded and analysed using descriptive statistics. Results Out of 130 responses recorded 45.4% of dentists prefer prescribing antibiotics daily. Amoxicillin was the most often recommended antibiotic by majority (49.6%) of the practitioners, While 54.6% of dentists considered a duration of 3 days course of antibiotics for odontogenic infections. 43.7% of the respondent’s considered clindamycin as an alternative in penicillin-allergic patients. Abscess was the most common (67.2%) condition considered for antibiotic prescription ,49.6% of the participants stated that availability of a particular brand as a primary factor for prescription of antibiotics. 40.3% of dental surgeons felt that failure to prescribe antibiotics was the main reason for the spread of infection. Almost 91.8% of dental surgeons were aware that antibiotic resistance was becoming a global concern. Conclusion Antibiotics revolutionized the way infections are being treated, Although incorrect and inappropriate use of antibiotics could be a contributing factor for the development of Antibiotic Resistance. Anti-microbial stewardship should be deeply integrated into dental practice and oral health care, to reduce the number of unnecessary prescriptions and educational intervention is utmost essential to limit non-medical prescriptions. Key Words Anti-microbial resistance in dentistry, Antibiotic prescribing patterns, Antibiotic resistance, Over-prescription

Outpatient Antibiotic Prescribing Patterns in Children among Primary Healthcare Institutions in China: A Nationwide Retrospective Study, 2017-2019.

There is scarce evidence to demonstrate the pattern of antibiotic use in children in China. We aimed to describe antibiotic prescribing practices among children in primary healthcare institutions (PHIs) in China. We described outpatient antibiotic prescriptions for children in PHIs from January 2017 to December 2019 at both the national and diagnostic levels, utilizing the antibiotic prescribing rate (APR), multi-antibiotic prescribing rate (MAPR), and broad-spectrum prescribing rate (BAPR). Generalized estimating equations were adopted to analyze the factors associated with antibiotic use. Among the total 155,262.2 weighted prescriptions for children, the APR, MAPR, and BAPR were 43.5%, 9.9%, and 84.8%. At the national level, J01DC second-generation cephalosporins were the most prescribed antibiotic category (21.0%, N = 15,313.0), followed by J01DD third-generation cephalosporins (17.4%, N = 12,695.8). Watch group antibiotics accounted for 55.0% of the total antibiotic prescriptions (N = 52,056.3). At the diagnostic level, respiratory tract infections accounted for 67.4% of antibiotic prescriptions, among which prescriptions with diagnoses classified as potentially bacterial RTIs occupied the highest APR (55.0%). For each diagnostic category, the MAPR and BAPR varied. Age, region, and diagnostic categories were associated with antibiotic use. Concerns were raised regarding the appropriateness of antibiotic use, especially for broad-spectrum antibiotics.

Antibiotic prescription pattern in pediatric intensive care unit in a tertiary care hospital: A cross-sectional study

Background: Incidence of infections in patients admitted to the Pediatric intensive care unit (PICU) is high which results in the use of antimicrobials for a prolonged duration and numbers. The rising incidence of antibiotic resistance has made it obligatory for antibiotics to be prescribed reasonably in pediatric patients. Aims and Objectives: The objective of this study was to analyze the antibiotic prescription pattern for patients admitted in pediatric intensive care unit in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted in PICU. Two hundred and seventy-five pediatric patients were incorporated in this study. The patients’ data were collected from the case sheets, recorded, and analyzed. Results: The majority (80%) of patients admitted in PICU received antibiotic(s). About 68.18% of patients were prescribed only one antibiotic. Patients in the age group of 1 m–&lt;1 year (58.18%) received more antibiotics. Pneumonia emerged to be the foremost reason for antibiotic use (45%), followed by Meningitis (14.54%). Ceftriaxone (28.27%) was the antibiotic prescribed most often. About 80.34% of antibiotics were prescribed by their generic names and 5.86% of antibiotics were prescribed as fixed-dose combinations. Conclusion: Antimicrobial resistance has become a global issue that should be tackled with extreme prudence and vigilance. This study provides insight on antibiotic prescription pattern in PICU and can prevent unnecessary use of antimicrobials.

Prescription pattern of antibiotics in dermatology: A Profile from a tertiary care teaching hospital, Kerala

Background: Antibiotics are commonly used in dermatology for infectious and inflammatory diseases. A study on the pattern of prescriptions will help in establishing fundamental data to enhance the utilization pattern of medications, elevate the standard of treatment, and enable prescribers to identify issues associated with drug usage, including adverse drug reactions, antibiotic resistance, drug interactions, and polypharmacy. Aim and Objective: The aim of the study was to describe the prescription pattern of antibiotics given to inpatients with dermatological disorders. Materials and Methods: This was a record-based descriptive study where the case records of 240 inpatients of the dermatology department of a tertiary care teaching hospital during the period from January 2019 to January 2022 were studied. The demographic profile, pattern of skin diseases reported, and pattern in antibiotic drugs usage were recorded with the help of a predesigned pro forma. Results: The mean age of the study population was 52.04 ± 16.91 years with male to female ratio 2.62:1. The most common skin disease diagnosed was Psoriasis (17.91%). Out of the 518 antibiotics prescribed to the patients in the study, the most preferred route of antibiotic administration was oral (48.84%). The most common oral antibiotic was cloxacillin (37.94%) while the most common parenteral antibiotic prescribed was cefotaxime (83%). Fusidic acid (78%) and mupirocin (16%) were commonly prescribed among the topical antibiotics. Amoxicillin-clavulanic acid combination (76%) was commonly prescribed among the fixed drug combinations. Among the topical antibiotics, 8.78% were prescribed as fixed-dose combination with steroids. Antibiotics (29%) constitute the major class of drugs among prescriptions followed by steroids (14%) and antacids (11%). Most of the prescribed antibiotics belonged to the Access group of antibiotics according to AWaRe classification of antibiotics (63.2%). Conclusion: The most common class of antibiotics prescribed was beta-lactam group of antibiotics. The study will help in formulating guidelines for rational prescription of antibiotics with special reference to dermatological cases and create awareness among physicians for effective therapeutic outcome. This will avoid the burden of antimicrobial resistance and pave pathway for the strengthening of economy.

Antibiotic Prescription Patterns among Pediatric Patients with Pneumonia in Primary Care – A Retrospective Cohort Study

Antibiotic Prescription Patterns among Pediatric Patients with Pneumonia in Primary Care – A Retrospective Cohort Study

Unveiling antibiotic utilization and resistance trends in urinary tract infections: A case record-based study

Background: Urinary tract infections (UTIs) are common infectious diseases associated with significant morbidity and mortality. Antibiotic resistance in uropathogens presents a growing challenge to effective UTI management, necessitating an understanding of epidemiological trends and treatment practices. This study investigates the epidemiology of UTIs and antibiotic resistance patterns within our local health-care setting. Aims and Objectives: The aim of this study was to analyze patient demographics, comorbidities, therapeutic approaches, antibiotic prescription patterns, culture and sensitivity testing results, and outcomes in UTI management. Materials and Methods: A retrospective analysis was conducted using medical records of UTI patients treated at our institution. Data were extracted and analyzed for patient characteristics and antibiotic resistance patterns. Statistical tests, including the Chi-square and Fisher’s exact tests, were employed to identify associations between patient characteristics and antibiotic resistance patterns. Results: Females comprised the majority (64.6%) of UTI cases, with Type 2 diabetes mellitus (68.66%) and hypertension (53.3%) being the most prevalent comorbidities. Empirical therapy was predominant (98.6%), with cephalosporins as the most commonly prescribed antibiotics. Escherichia coli was the predominant organism isolated (50%) in culture, with varying resistance patterns. Ciprofloxacin exhibited the highest resistance (59.5%), while gentamycin showed the highest sensitivity (68.7%). Prescription alterations post-culture revealed a shift toward nitrofurantoin as the most commonly prescribed antibiotic. Conclusion: This study provides insights into UTI epidemiology and antibiotic resistance patterns in our local health-care setting. The observed gender disparity and prevalence of comorbidities highlight the complexity of UTIs and their association with underlying health conditions. Empirical therapy remains the cornerstone of UTI management, emphasizing the need for judicious antibiotic prescribing practices. Tailored antimicrobial stewardship strategies are essential to address antibiotic resistance emergence and optimize patient outcomes in UTI management.

Assessment of antimicrobial drugs employed at government-operated hospitals in central and northern provinces of Iraq.

Aim: To document the clinical patterns of antibiotic prescriptions in government hospitals, where the majority of physicians possess a degree-based training. Materials and Methods: A Retrospective cross section study carried out between 1/7/2022 and April 2023 that enrolling 300 patients from governmental hospitals from different provinces of Central and northern Iraq. The research form contained 15 fields divided into three sections. The first section contains social information such as age, gender, field of work, Residence and education. The second part consists of diagnosis and lab. Finding. The third part related to antibiotic uses: Number of AB prescribed, duration of using, type of use, route of administration, AB interaction, dose administration of AB, indication of Ab, and Class of AB. Results: A total of 300 eligible patients, 165 patients (55.0%) were male and 135 (45.0%) were female, patients were <20 years ages were 117 (39.0%), 25 (8.3%) from the 20-29 years age group, 40-49 years ages were 28 (9.3%) and >50 years ages were 105 (35.0%) were which belong to the pediatric population. The 198 patients (66.0%) were used cephalosporins and 106 (53.5%) of them used alone. A 13-19% percentage of patients had used penicillin, carbapenem, anti-fungal, and aminoglycoside in combination form. Conclusions: The implementation of clinical guidelines, the provision of direct instruction, and the regular dissemination of antibiogram data have the potential to encourage a more judicious consumption of antibiotics.

Evaluation of antibiotic prescribing patterns for surgical prophylaxis before and after an educational campaign about penicillin allergies: a single-center, retrospective study.

After an educational campaign about reasonable use of cefazolin for surgical prophylaxis, optimal preoperative antibiotic regimen utilization increased from 52% to 67% (P = 0.011). Education to physicians on penicillin allergies may contribute to meaningful increases in use of optimal antibiotics while reducing readmissions and acute care length of stay.

Prescribing Patterns of Antibiotics in Pediatric Wards of Secondary Care Centers: A Retrospective Study Based on WHO AWaRe Classification.

Objectives. Antimicrobial resistance (AMR) poses a significant threat to global public health, with substantial mortality rates attributed to AMR-related infections. Pediatric populations face heightened vulnerability due to prevalent antimicrobial misuse. This study aimed at addressing the significant threat of antimicrobial resistance (AMR) and its associated mortality rates. Methods. This retrospective cross-sectional multicentric study investigated antibiotic prescribing patterns in pediatric wards of 4 secondary care hospitals affiliated with Aga Khan University Hospital. The study utilized the WHO Access, Watch, and Reserve (AWaRe) classification framework. Data from 6934 encounters were analyzed. Results. Antibiotics were prescribed in 78.1% of encounters, with intravenous administration being predominant (98.6%). Ceftriaxone was the most prescribed antibiotic agent (45.8%), and third-generation cephalosporins constituted the most prevalent antibiotic class (54.4%). Pneumonia exhibited the highest prescription rate (99.9%), with Watch group antibiotics being predominantly prescribed (>80%) across hospitals. Conclusion. These findings underscore the urgency for targeted interventions to optimize prescribing practices and mitigate resistance.

Antibiotics for Pediatric Patients With Laryngotracheobronchitis in Korea: A Nationwide Study Based on Administrative Data.

Antimicrobial resistance (AMR) is an important global public health concern in adults and children. Laryngotracheobronchitis (croup) is a common acute respiratory infection (ARI) among children, most often caused by a virus, and should not be treated with antibiotics. Reducing the usage of unnecessary antibiotics in ARI using an antimicrobial stewardship program (ASP) is an effective measure against AMR in children. This study investigates the antibiotic prescription pattern in pediatric patients with laryngotracheobronchitis in Korea. Our results will be useful to improve the ASP. The data were obtained from the government agency Health Insurance Review and Assessment Service. We analyzed outpatient prescriptions issued to children ≤ 5 years of age with a first-listed diagnosis code for laryngotracheobronchitis, i.e., International Classification of Disease, 10th Revision, code J050 (croup), J040 (laryngitis), or J041 (tracheitis), during 2017-2020. For each prescription, demographic information and information about medical facilities visited (type of hospital, specialty of physician, location of hospital) were extracted. The overall antibiotic prescription rate was subsequently estimated, and multivariable analysis was conducted to determine the associated factors of antibiotic prescription. Prescribed antibiotics were described and classified into extended-spectrum penicillins, cephalosporin, and macrolides. Of 2,358,194 prescriptions reviewed, 829,172 (35.2%) contained antibiotics. In the multivariable analysis, management in a hospital was the strongest factor associated with antibiotic prescription (adjusted odds ratio [aOR], 22.33; 95% confidence interval [CI], 20.87-23.89; P < 0.001), followed by management in a clinic (aOR, 12.66; 95% CI, 11.83-13.54; P < 0.001) and management in a general hospital (aOR, 8.96; 95% CI, 8.37-9.59; P < 0.001). Antibiotic prescription was also significantly associated with patients who were ≤ 2 years of age, managed by a pediatric specialist, and treated at a hospital located in a non-metropolitan region. Overall, extended-spectrum penicillins were the most frequently prescribed (18.6%) antibiotics, followed by cephalosporins (9.4%) and macrolides (8.5%). The results of our study suggest that ASPs need to focus on physicians in hospitals, clinics, general hospitals, and pediatric specialties. Providing education programs to these groups to increase awareness of AMR and appropriate antibiotics use could be effective ASP policy and may help to reduce unnecessary prescriptions of antibiotics for laryngotracheobronchitis among pediatric patients and therefore potentially AMR in children in Korea.

Evaluating Antibiotic Treatment Guideline Adherence to Ongoing Antibiotic Stewardship in a Tertiary Care Setting: A Retrospective Observational Study.

Antimicrobial resistance (AMR) is widely regarded as an increasing threat to global public health. Antibiotic treatment guidelines have been increasingly recognized as an effective tool to guide appropriate prescriptions and help curtail antibiotic resistance. The present study aimed to assess physician's adherence to hospital antibiotic treatment guideline recommendations in Nepal and determine predictive variables with a significant association. This was a retrospective, monocentric observational review to investigate the adherence to endorsed guidelines using the medical records of adults admitted to the hospital with a diagnosis of urinary tract infection (UTI), pneumonia, or skin and soft tissue infection (SSTI) from January 2018 to December 2019. Of the 2,077 medical records that were reviewed (954 UTI, 754 pneumonia, and 369 SSTI), 354 (17%) met the study inclusion criteria, which included 87 UTI, 180 pneumonia, and 87 SSTI patients. Among eligible patients with antibiotic prescriptions, the following were adherent to guideline recommendations: 33 (37.9%) UTI, 78 (43.3%) pneumonia, and 23 (26.4%) SSTI. The overall extent of adherence to hospital antibiotic treatment guidelines for the use of antibiotics among adult inpatients diagnosed with these common infections was 37.9%. Patients who received ceftriaxone (OR = 2.09, 95% CI = 1.18-3.71, p=0.012) and levofloxacin (OR = 4.63, 95% CI = 1.30-16.53, p=0.018) had significantly higher adherence to treatment guidelines. This study revealed a low adherence rate despite the availability of updated guidelines for antibiotic prescriptions. The findings confer an urgent need to confront antibiotic prescription patterns in such tertiary care centers for tailored interventions to improve adherence to antibiotic guidelines.

Impact of an antibiotic stewardship program on adherence to antibiotic prescription in children admitted with urinary tract infection.

Urinary tract infections (UTIs) are the most common bacterial infections in children. The high variability in pathogen susceptibility rates leads to the lack of clear guidelines for empiric and targeted therapies. In this view, local microbiological surveillance and locally adapted stewardship interventions need to be implemented. The study aims to describe the results of a pediatric antimicrobial stewardship program on antibiotic prescriptions for UTIs over 8 years in a pediatric general ward of a tertiary center. This quasi-experimental study was conducted between 2015 and 2022, with two different implementations, one in 2018 and one in 2021. Demographic, clinical, microbiological, and therapeutic data were retrieved from the electronic clinical records of included patients. The primary outcomes were adherence to local guidelines for empiric therapies and the adequacy of targeted therapy. Secondary outcomes were evaluating antibiotic prescription patterns stratified by antibiotics during hospital stay and at discharge, and assessing the microbiological characteristics of UTI episodes. During the study period, 7038 patients were admitted to the pediatric acute care unit (PACU), and 264 (3.7%) were included in this study. Adherence to local guidelines was highest immediately after the interventions, and it slightly decreased thereafter. Use of cephalosporins remained high throughout the 8 years but the changing microbiological scenario observed led to changing recommendations within the study period. An increase in E. coli strains resistant to co-amoxiclav was observed in the last years. Oral second-line agent consumption remained high but was adequate considering the prevalence of resistant bacteria. The variability of antimicrobial consumption reflects the changing resistance patterns for UTIs pathogens, underlying the importance of locally adapted, persevering antimicrobial stewardship interventions.

Prescription pattern of antibiotics in urinary tract infection based on antimicrobial susceptibility test at a tertiary care hospital

Introduction: Urinary tract infection is a common bacterial infection associated with significant morbidity, mortality, and financial burden. This study aimed to identify the causative bacteria, assess their antimicrobial susceptibility patterns and evaluate empirical and definitive antibiotic therapy for urinary tract infection. Methods: A hospital-based crosssectional study was conducted at the outpatient medicine department at a teaching hospital in Nepal from February 15 to July 14, 2022. Two hundred participants with positive urine cultures and antimicrobial susceptibility testing were included. The microorganism causing urinary tract infection and prescription pattern of antibiotics pre-and post-AST report were analyzed. Results: The majority of isolated pathogens were gram-negative bacteria (73%), with Escherichia coli being the most common (53.5%), followed by Staphylococcus aureus among gram-positive bacteria (14.5%). Female patients had a higher incidence of urinary tract infection (59.5%) than males (40.5%). The age group above 60 years had the highest occurrence (34%). Antibiotic susceptibility testing revealed that Escherechia coli exhibited higher sensitivity to nitrofurantoin, amikacin, and meropenem, while resistance was observed against ampicillin, cefixime, and norfloxacin. Empirical antibiotics were commonly prescribed, with levofloxacin and ceftriaxone being the most frequent choices. After antibiotic susceptibility testing, nitrofurantoin and levofloxacin were frequently prescribed. Conclusions: This study provides valuable insights into the etiology of urinary tract infection and antibiotic susceptibility patterns, aiding in selecting appropriate antimicrobial therapy based on local resistance patterns.

Prescribing Pattern of Antibiotics in Paediatric Inpatients of Bakulahar Ratnanagar Hospital, Chitwan

INTRODUCTION: The rational use of antibiotics is crucial in paediatric healthcare settings to mitigate the risk of antimicrobial resistance. This study aimed to assess the prescription patterns of antibiotics among paediatric inpatients at Bakulahar Ratnanagar Hospital, Ratnanagar, Chitwan. MATERIALS AND METHODS: A cross-sectional study conducted over a 2-month period in May-June 2023 involved the analysis of 160 patient case sheets from the paediatric inpatient department. Patients with various infections were included, and data were analyzed using SPSS. RESULTS: The mean age of paediatric patients was 2.83 years. Each encounter involved an average of 3.4 drugs, with 1.86 antibiotics per patient. Pneumonia emerged as the most prevalent disease. Among antibiotics, the Cephalosporin group, particularly Ceftriaxone and Cefotaxime, were frequently prescribed. The combination antibiotic Ceftriaxone plus Tazobactam was widely used. CONCLUSIONS: Strict adherence to antibiotic prescription policies can significantly curb overuse and reduce antibiotic resistance development.

Prescribing Pattern of Antimicrobials for Respiratory Tract Infections among Paediatric population in a Multi- Speciality Teaching Hospital

Respiratory Tract Infection (RTI) is one of the leading causes of paediatric mortality. Majority of RTIs are viral in origin. Bacterial pathogens associated with upper and lower respiratory tract infections are Streptococcus pneumoniae, Haemophilus influenza and Moraxella catarrhalis. Antibiotics are considered as the key drugs of choice for the treatment of many infections and they are most commonly prescribed drugs in paediatric department of RTI. Antibiotic regimen should be selected based on presumed causative pathogen. In view of the higher burden of RTI among paediatrics in this area, a study is taken up to analyse the prescribing pattern of antibiotics in RTI. The prospective study was conducted for a period of 6 months. Case records of 156 patients were selected based on the study criteria. A suitably designed data collection form was used to collect the required data. Statistical analysis was done using Microsoft Excel.In this study, there was a slight female predominance (50.64%) and the most prevalent age group was 0 - 3 years (44.88%). LRTI (55.77%) was extensively distributed among the study population in which WALRTI constituted the highest (25.65%). Penicillin (33.15%) class of antibiotics were the most preferred followed by cephalosporin (30.97%). Amoxicillin-clavulanate (26.02%) and Ceftriaxone (21%) were the highly prescribed antibiotics among penicillin and cephalosporins respectively. Majority of patients received antibiotics intravenously. Monotherapy was encouraged in 66.64% of patients. It is essential to improve the utilisation of drugs and therefore analysis of prescription pattern should be carried out frequently to enhance the quality of prescriptions. The study results aim at focusing the importance of strategies that have to be implemented to rationalise the use of medications in paediatrics. Drug utilization studies are vital to promote optimal use of antimicrobials to ensure the best clinical outcome and to address the concern of antimicrobial resistance.

Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications.

Antimicrobial resistance (AMR) is a global public health problem that is fuelled by the inappropriate prescribing of antibiotics, especially those from the 'watch' and 'reserve' antibiotic lists. The irrational prescribing of antibiotics is particularly prevalent in developing countries, including Zambia. Consequently, there is a need to better understand prescribing patterns across sectors in Zambia as a basis for future interventions. This study evaluated the prescribing patterns of antibiotics using the WHO prescribing indicators alongside the 'access, watch and reserve' (AWaRe) classification system post-COVID pandemic at a faith-based hospital in Zambia. A cross-sectional study was conducted from August 2023 to October 2023 involving the review of medical records at St. Francis' Mission Hospital in Zambia. A WHO-validated tool was used to evaluate antibiotic prescribing patterns alongside the AWaRe classification tool. Out of 800 medical records reviewed, 2003 medicines were prescribed. Each patient received an average of 2.5 medicines per prescription. Antibiotics were prescribed in 72.3% of encounters, of which 28.4% were injectable. The most frequently prescribed antibiotics were amoxicillin (23.4%-access), metronidazole (17.1%-access), ciprofloxacin (8%-watch) and ceftriaxone (7.4%-watch), with 77.1% overall from the 'access' list. Encouragingly, 96.5% of the medicines were prescribed by their generic names and 98% were from the Zambia Essential Medicines List. There were high rates of antibiotic prescribing, including injectable antibiotics, which needs addressing going forward. It is crucial to implement targeted measures, including antimicrobial stewardship programmes, to improve future antibiotic prescribing in Zambia and reduce the risk of AMR.

Antibiotic utilization profile in surgical ward at secondary government hospital

Background: This study aimed to determine the profile of the antibiotic utilization in defined daily dose (DDD) units and DU 90% at surgical ward of secondary government hospital in Indonesia within six months period of study. Methods: A retrospective cross-sectional study was conducted over six months on surgical ward patients prescribed with at least one oral or parenteral antibiotic during hospitalization. Data were collected from pharmacy dispensing data and evaluated using World Health Organization (WHO) DDD. Antibiotics DDD were analysed using DU 90% segmentation in order to know the 90 percent cumulative of antibiotic consumption in surgical ward. WHO prescribing indicators were used to examine the antibiotic prescribing pattern in DU 90% segment. Results: Out of 319 antibiotic prescribed to surgical ward patients, 219 prescriptions were belonging to DU 90% segment including ceftriaxone (38.94%), moxifloxacin (16.41%), fosfomycin (14.06%), metronidazole (12.43%), and gentamicin (7.69%) in decreasing fashioned. Of the five groups of antibiotics belong to DU90%, ceftriaxone was the highest in DDD (272.5). The average number of antibiotic prescribed to patients were 1.64±0.92. The percentage of antibiotic prescribed by its generic name as well the prescribing of antibiotic from National list of essential medicines were 70.79% and 72.51%, respectively (optimal value 100%). Conclusions: Our findings on using drug utilization 90% and prescribing indicators are practical for assessing the most widely used antibiotics in ward or hospital setting and to evaluate the quality of prescribing pattern. The antibiotic utilization profile in this study can be used to provide comparative data between hospital and beneficial for future policy making to improve prescribing practice.

Interpretation using PRISMA 2020 methodology of antibiotic use in dentistry

The objective of this study is to interpret the use of antibiotics in dentistry using the PRISMA 2020 methodology. An integrative bibliographic review was conducted using PubMed, covering publications from 2019 to 2024. The search focused on identifying practices and patterns of antibiotic prescription in dentistry. Ten relevant studies were included, evidencing the prevalence of inappropriate antibiotic prescriptions and the impact of bacterial resistance. Findings highlight that antibiotic prophylaxis in dental procedures is often unjustified, contributing to antimicrobial resistance development. Additionally, a shift towards more rational prescribing guidelines was observed in some contexts. Recommendations include improving the education and continuous training of dental health professionals and establishing stricter policies for the regulation of antibiotic prescriptions and sales

Drug Utilization Research and Predictors of Outcomes in the Intensive Care Unit of a Tertiary Care Hospital: A Prospective Observational Study.

Multiple drugs are commonly prescribed to intensive care unit (ICU) patients owing to the disease profile, multiple organ dysfunction, prophylaxis, management of stress ulcers, nosocomial infections, etc. This study aimed to evaluate the drug utilization patterns and factors influencing mortality and duration of stay in ICU patients. Methodology: A prospective observational study was conducted in the ICUof our tertiary care hospital, Postgraduate Institute of Medical Sciences, Rohtak. Data was collected from treatment charts of patients using a structured pretested proforma. World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose (WHO ATC/DDD) methodology and core prescribing indicators were used to assess drug utilization data. The effect of different variables on mortality and duration of stay in the ICU was evaluated using regression analysis. An average of 8.78 drugs were prescribed per patient. Among the 922 prescriptions, anti-infectives, anti-inflammatory drugs, and drugs acting on the gastrointestinal tract were the most frequent medication classes prescribed. Polypharmacy and trade name prescribing were common. For most of the drugs, the prescribed daily dose corresponded to the WHO-DDD except ceftriaxone and levofloxacin. Age, presence of cardiac disorders, and Glasgow Coma Scale (GCS) score at admission directly correlated with mortality while the use of diuretics had a negative correlation with the duration of ICU stay. Conclusions: There is a need to rationalize drug therapy in the ICUwith regard to limiting polypharmacyand emphasizing generic drug name prescribing and adherence to the essential drug list. Antibiotic prescription patterns, in particular, deserve a special focus keeping in mind the multitude of factors demanding aggressive antibiotic use in critically ill intensive care patients.