Antibiotic Prescribing Patterns Research Articles

Evaluation of antibiotics utilization in an intensive and critical care unit of a tertiary care teaching hospital in West Bengal: An observational study

Background: Resistance to antibiotics is rising markedly. Factor which contributes to resistance is the rampant irrational use of antibiotics. The trend of prescribing antibiotics in intensive care units (ICUs) of eastern India is less explored. Aims and Objectives: The aim of the study was to describe and analyze the utilization of antibiotics as per the WHO/INRUD prescribing core indicators in an intensive and critical care unit (CCU) of a tertiary center in eastern India. Materials and Methods: A prospective observational study was carried out on prescription pattern of antibiotics. Case records of patients with restricted antibiotic therapy were reviewed and evaluated using descriptive statistics. A total of 353 prescriptions were evaluated and analyzed. Results: Among the total 353 patients most common age group admitted was 41–60 years. Males were more in numbers. Myocardial infarction and post-operative complications were the most common cause of admission in ICU and CCU, respectively. Ceftriaxone (44%) and meropenem (37%) were the drugs used rampantly in ICU and CCU. More than 90% of prescriptions had injections and drugs were written in generic names. Almost 90% of patients in CCU had antibiotics in their prescription. Adverse events occurred in 14.7% of patients and thrombophlebitis was the most common adverse event occurred. Conclusion: The study has given us an overall impression of the antibiotics usage pattern in ICU and CCU of this teaching institution. The study has shown that antibiotics should be used judiciously in ICU and CCU. Policy can be made on the basis of the result of this study.

Prescription Pattern of Antibiotics in Admitted Patients of a Tertiary Care Government Teaching Hospital, Kerala, India

Introduction: Antibiotics have a remarkable role in prolonging life, especially in underdeveloped and developing countries. Insufficient knowledge among doctors, peer pressure and patient demands, diagnostic uncertainties, lack of communication between the doctor, pharmacist and patients all implicate inappropriate antibiotic prescribing practices. Irrational antibiotic prescription can lead to antibiotic resistance, marking a global crisis. Aim: To evaluate the prescription pattern of antibiotics in the admitted patients of a tertiary care teaching hospital and assess the prescriptions' rationality. Materials and Methods: This was a retrospective record-based study done in the inpatients of Government Medical College, Manjeri, Kerala, India, for three months (1st October 2017 to 31st December 2017). Data was collected using a data collection checklist which included patient identity and demographic factors, name and route of the antibiotic prescribed, usage of multiple antibiotics, usage of prophylactic antibiotic, usage of generic names, adherence to National List of Essential Medicines (NLEM) and rational use. The data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0 and frequencies and percentages were determined for each variable. Results: Total 1,186 medical records were analysed, and 49.7% were prescribed antibiotics; 38.2% contained more than one antibiotic, and 64.8% contained parenteral antibiotics. Cefotaxime was found to be the most commonly prescribed antibiotic. An 88.3% of prescriptions were adhering to NLEM, and 29% contained generic names of antibiotics. Overall, 69 out of 589 (11.7%) were irrational prescriptions, and the use of multiple antibiotics with the same spectrum of coverage was found to be the most common reason for irrationality. Conclusion: In this study, the most drugs were prescribed from the NLEM. Cephalosporins were the most commonly used antibiotics for the inpatients in this hospital. Prescriptions with generic names of drugs were low. Irrational prescriptions contributed a minor percentage, and reserve antibiotics were too little.

Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia

Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely; Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.

Antibiotic Prescribing Patterns and Prevalence of Surgical Site Infections in Caesarean Section Deliveries at Two Tertiary Hospitals in Lusaka, Zambia

Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p < 0.001), and 99.8% of the women received antibiotic(s). The antibiotic combination of benzylpenicillin, gentamicin, and metronidazole was the most commonly prescribed (n = 39, 146.7%), followed by ceftriaxone (n = 349, 41.6%). Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.

Analysis of antibiotic prescriptions in patients with community-acquired pneumonia in clinical practice

Objective. To analyze new strategies for the treatment of community-acquired pneumonia (CAP) by age and assess treatment efficacy by age category based on real world data. Materials and Methods. A total of 612 patients (medical charts) with CAP treated in 3 hospitals during the 2017–2019 were included in the retrospective pharmacoepidemiological study. A retrospective analysis of antimicrobial therapy (AMT) administration in the treatment of CAP was performed. Results. Duration of hospital stay in CAP patients of young age was 10% shorter than in patients of any other age category. The least frequency (19.6%) of antibiotic combination administration as initial empiric therapy was found in patients of young age. There were no significant differences in frequency of initial AMT administration between age groups. Ceftriaxone, cefepime and cefoperazone were the most common antimicrobials used as monotherapy in all age groups. Ceftriaxone with azithromycin combination was the most common (42%) initial combination therapy in all age groups. The highest number (27) of various antibiotic combinations was administered to old patients, and the lowest number (16) – to young patients. Efficacy of initial AMT was similar between elderly and old patients. Overall efficacy of initial AMT in patients with non-severe CAP and severe CAP was 54% and 50%, respectively. Analysis of antimicrobial treatment of CAP in real practice and its compliance with the current clinical guidelines showed cephalosporin plus macrolide to be a predominant antibiotic combination (83%). Conclusions. Antibiotic combination administration was found to be common in patients with non-severe CAP, whereas initial monotherapy was administered to severe CAP patients. Antibiotic prescription pattern in patient of young age was different from that in any other age groups. CAP had a less severe course in young patients as evidenced by shorter duration of hospital stay, more frequent monotherapy administration and higher efficacy of initial AMT compared to other age categories. There were no prescriptions of the recommended fifth generation cephalosporin (ceftaroline fosamil).

Antibiotic-prescribing pattern in the outpatient departments using the WHO prescribing indicators and AWaRe assessment tool in a tertiary-care hospital in South India

Context:Rational drug use has a great role of influence in health care. The fact sheet given by the World Health Organization (WHO) shows that around 50% of the drugs are prescribed, dispensed, and sold inappropriately. One of the major consequences of irrational drug use in infections is antibiotic resistance.Aim:The present study aims to assess the antibiotic-prescribing pattern by auditing the prescriptions in a teaching hospital.Settings and Design:A prospective cross-sectional study was conducted in the pharmacy of a teaching hospital to evaluate the prescriptions of the outpatient department.Materials and Methods:The prescriptions used to treat symptoms suggestive of infections were taken into consideration. A total of 1,000 prescriptions were analyzed.Data Analysis:The data was analysed using Microsoft Excel.Results:A total of 2,536 drugs were prescribed. The average number of drugs per prescription was 2.5. The percentage of encounters with antibiotics prescribed was 17.5%. The percentage of encounters prescribed with a generic name and with drugs from the essential drug list was 87.5% and 65%, respectively. There were no injections prescribed. Amoxicillin and ciprofloxacin were the most common antibiotics prescribed. The duration of the treatment was mentioned in all the prescriptions.Conclusions:Our study shows that the percentage of antibiotic usage is within the WHO standard value. The average number of drugs per prescription was slightly higher than the WHO value. Steps should be taken to improve the generic prescribing by the physicians.

Evaluation of systemic antibiotic usage in the treatment of periodontal diseases among dental professionals in Turkey: Cross - sectional epidemiological study

Background/Aim: Systemic antibiotic use in periodontal diseases has increased in recent years. The purpose of this study was to investigate the antibiotic prescribing patterns for systemic antibiotics for the treatment of periodontal diseases. Material and Methods: A prepared questionnaire was sent to the e-mail addresses of dentists located in seven different regions of Turkey, who were requested to reply the questions online. In total, 512 emails were sent for the study, which was carried out with the participation of general dentists (GDs), periodontists (PDs), and specialist dentists (SDs). The participants were asked questions about their professional experiences, the institutions that they work for, and their antibiotic training and knowledge, their perspectives on clinical antibiotic use and antibiotic preferences invarious clinical situations. Results: 65.5% of GDs, 23.3% of PDs, 11.6% of SDs participated in this study. In reviewing the participants' systemic antibiotic use to treat periodontal diseases, most preferred systemic antibiotics to treat acute necrotizan ulcerative gingivitis, aggressive periodontitis, diabetes associated periodontitis. Regarding antibiotic prescriptions, 40.7% of the GDs and 34.8% of the SDs prescribed 1-3 antibiotics per day. Meanwhile, 31.3% of the PDs prescribed 1-3 antibiotics a day and 31.3% 1-4 antibiotics a week (p&lt;0.005). Conclusions: Based on the results of this survey, shows that dentists do not have sufficient training for systemic antibiotic use and that their current approach is based on clinical experience alone. Clearer, more specific guidelines and increased post-graduate education can lead to a reduction in the negative consequences of this issue's resultant over-prescribed antibiotics.

Access–Watch ratio based on access, watch, and reserve classification of antibiotics in public health facilities of Tamil Nadu

The rise in cases of antibiotic resistance can be mainly attributed to the overuse and misuse of antibiotics. To address this issue, the WHO launched Access, Watch, and Reserve (AWaRe) classification of antibiotics in 2017 as a surveillance tool. Many countries have adopted it to monitor and optimize their antibiotic usage. However, implementation of it is yet not seen at a very appreciable level. Through this survey, we tried to explore the prescribing pattern of antibiotics based on the WHO AWaRe classification in selected secondary and tertiary care health facilities of Tamil Nadu. In-patient case sheets were audited in selected departments across 18 health facilities in six districts. Proportionately higher use of the watch group of antibiotics was found in all the districts. A lower access-watch ratio suggests the need for judicious implementation of such tools to safeguard this life-saving good and ensuring its sustainability.

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state.

The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

Analysis of recurrent urinary tract infection management in women seen in outpatient settings reveals opportunities for antibiotic stewardship interventions.

We characterized antibiotic prescribing patterns and management practices among recurrent urinary tract infection (rUTI) patients, and we identified factors associated with lack of guideline adherence to antibiotic choice, duration of treatment, and urine cultures obtained. We hypothesized that prior resistance to nitrofurantoin or trimethoprim-sulfamethoxazole (TMP-SMX), shorter intervals between rUTIs, and more frequent rUTIs would be associated with fluoroquinolone or β-lactam prescribing, or longer duration of therapy. This study was a retrospective database study of adult women with International Classification of Diseases, Tenth Revision (ICD-10) cystitis codes meeting American Urological Association rUTI criteria at outpatient clinics within our academic medical center between 2016 and 2018. We excluded patients with ICD-10 codes indicative of complicated UTI or pyelonephritis. Generalized estimating equations were used for risk-factor analysis. Among 214 patients with 566 visits, 61.5% of prescriptions comprised first-line agents of nitrofurantoin (39.7%) and TMP-SMX (21.5%), followed by second-line choices of fluoroquinolones (27.2%) and β-lactams (11%). Most fluoroquinolone prescriptions (86.7%), TMP-SMX prescriptions (72.2%), and nitrofurantoin prescriptions (60.2%) exceeded the guideline-recommended duration. Approximately half of visits lacked a urine culture. Receiving care through urology via telephone was associated with receiving a β-lactam (adjusted odds ratio [aOR], 6.34; 95% confidence interval [CI], 2.58-15.56) or fluoroquinolone (OR, 2.28; 95% CI, 1.07-4.86). Having >2 rUTIs during the study period and seeking care from a urology practice (RR, 1.28, 95% CI, 1.15-1.44) were associated with longer antibiotic duration. We found low guideline concordance for antibiotic choice, duration of therapy and cultures obtained among rUTI patients. These factors represent new targets for outpatient antibiotic stewardship interventions.

POSA369 Prescribing Practices of Antibiotics in the Acute Gastroenteritis in a Tertiary Care Hospital: A Retrospective Study

Antibiotics are essential drugs helpful in treating various infectious diseases besides other medications, even in gastroenteritis. Hence, assessment of antibiotic prescribing patterns helps in understanding the use of drugs & standards of clinical practice. 1-5

Factors influencing decision making and antibiotic prescribing patterns for the treatment of carbapenem-resistant Enterobacteriaceae (CRE) among non-infectious physicians in Thailand: a qualitative study.

The treatment of carbapenem-resistant Enterobacteriaceae (CRE) is diverse in each region due to the difference in local resistant patterns of CRE. We aimed to explore how physicians in Thailand decide on selection options for treating CRE infections. In this study, 25 physicians who were not infectious disease (ID) specialists participated in this semi-structured in-depth interview. We found that they, in general, did not provide empiric antibiotics for the treatment of CRE. However, some patients, e.g., those with prior carbapenems exposure may have brought CRE to physicians' attention. ID specialists played critical roles in both empiric and specific CRE treatment. There were multiple scenarios when CRE management deviated from recommendations, especially when physicians perceived that the evidence that supported the recommendations was weak. Several supportive factors, challenges, and improvements were also suggested. In conclusion, ID specialists, adequate information, and consistent implementation of infectious control policy are crucial to the treatment and prevention of CRE infection.

Antimicrobial Prescription Patterns among Oral Implantologists of Kerala, India: A Cross-Sectional Survey.

Background and Objectives:Antimicrobial resistance is a grave public health concern, and it is important to optimize the use of antimicrobials in dental surgeries. Antimicrobial prescriptions in dental implant placements are often empiric and not guided by consensus or specific guidelines. The aim of this study was to elucidate antibiotic prescribing patterns among oral implantologists. The objectives were to identify the frequency of antimicrobial usage and preferences regarding the perioperative timing of prescriptions, type of antibiotic, dosage, and duration in different implant placement scenarios.Subjects and Methods:An anonymized web-based survey was carried out. Participants were drawn from the lists of oral implantologists from all local branches of the Indian Dental Association in the state of Kerala, India, until the required sample size was met. Responses were recorded using an Internet-based validated questionnaire sent via e-mail to the participants. The questionnaire contained five sections with both open-ended and closed-ended questions.Results:Among the 93 participants, 59% of the dental implantologists preferred 0.2% povidone-iodine as a preprocedural mouth rinse in the backdrop of the COVID-19 pandemic, and 68% prescribed 0.12%–0.2% chlorhexidine as the postoperative mouth rinse. The majority of the participants (73%) routinely prescribed systemic antibiotics perioperatively during implant placement surgery. Interestingly, while none of the participants preferred a solely preoperative regimen, 92.4% of the dentists in our survey prescribed both pre- and postoperative antibiotics. Antibiotics of choice as the preoperative agents were amoxicillin and amoxicillin plus clavulanic acid. The most preferred postoperative agent was amoxicillin plus clavulanic acid. The popularly reported rationale behind a preoperative antibiotic was to decrease or eliminate local or systemic infections (79%), and the majority of the participants (60%) prescribed postoperative antibiotics to prevent postoperative infection.Conclusions:Systemic antibiotic prescriptions in implant placement surgery are not based on currently available evidence. Most oral implantologists who participated in the survey prescribed systemic antibiotics to prevent perioperative infection, even in simple and straightforward implant placements. Specific guidelines need to be generated in complex implant placement situations and implant placement in medically compromised patients to prevent excessive prescriptions.

Inpatient antibiotic prescribing patterns using the World Health Organization (WHO) Access Watch and Reserve (AWaRe) classification in Okinawa, Japan: A point-prevalence survey.

Using point-prevalence methodology and the World Health Organization (WHO) Access, Watch, and Reserve Classification, we measured antibiotic use in 5 hospitals in Okinawa, Japan, on October 1, 2020. Overall, 29% of patients were prescribed an antibiotic on the survey date and the 3 most used antibiotics in the "Watch" category were cefazolin, ampicillin-sulbactam, and ampicillin.

Influence of CRP on Antibiotics Prescription Pattern for Dental Infections: A Prospective Interventional Study

Introduction: Over the years, antibiotic prescription rates have increased dramatically for the treatment of dentoalveolar infections. A byproduct of this indiscriminate antibiotic prescription by dentists is the antibiotic resistance. Antibiotic resistant infections are a severe global health problem, putting the capacity to treat common diseases and perform complex medical procedures at risk. Aim: To compare the amount of antibiotics prescribed for dental infections with and without analysing C-reactive Protein (CRP) value. Materials and Methods: A prospective interventional study was conducted in Manipal University College Malaysia (MUCM) dental clinic between October 2020 to March 2021 to record the antibiotic prescription by dentists. The study was divided into two phases where phase I had 28 subjects and phase II had 21 subjects and permission from institutional ethical committee clearance was obtained for the study. The study was done to evaluate the effectiveness of C-reactive protein (CRP) to reduce antibiotic prescriptions in MUCM Dental Clinic. Data was summarised by computing frequency and percentages. The antibiotic prescription rate during phase I (n=28) (conventional method or routine pattern of prescribing antibiotics was done) and phase II (n=21) (CRP rapid test was done and the decision whether to prescribe antibiotics or not was done accordingly) was compared. The data was analyzed by using Statistical Package for the Social Sciences software program (SPSS), version 15.0 (South Asia, Bangalore) and compared applying the Chi-square test. Results: There was no significant difference in the distribution of the presence of medical condition (p=0.201) and distribution of clinical features (p=0.804) of subjects included in phase I and phase II. The antibiotics prescription rate reduced significantly from 89.3% in phase I to 52.4% in phase II (p=0.0014), indicating that CRP rapid test helps in reducing antibiotics prescription. Conclusion: The CRP rapid test aid in lowering antibiotic prescription in dental clinic settings. This may be useful to combat antibiotic resistance in general.

Enhancing the empiric antibiotic selection by introducing an antibiogram toolkit in a tertiary care hospital in Southern India - A prospective study.

Antibiograms gives an overview of the cumulative susceptibility of formal antibiotics to bacterial isolates, which reflects the portion of each bacterium susceptible to a given antibiotic formulation by using antimicrobial susceptibility testing. The objective of this study is to gather and analyse data from drug utilization evaluation (DUE) studies and antimicrobial susceptibility tests in order to create an antibiogram toolkit that will help clinicians to select appropriate antimicrobial agents for initial empirical antibiotic therapy at point of care settings and avoid irrational use of antibiotics. A prospective interventional study was conducted at tertiary care hospital, biological samples of infectious patients were collected from various wards as per Clinical & Laboratory Standards Institute CLSI M39-A4guidelines. Antimicrobial susceptibility results were analysed using WHONET software. Antibiotic stewardship committee was formed and involved in monitoring the usage of antibiotics, measuring outcomes, collecting feedback and finding the scope for improving the application of antibiogram toolkit in the hospital. Antibiotic usage tracking method was followed to know the level of adherence to the prescribing guidelines by the health care professionals. A total of 157samples were obtained from various wards of the hospital. In that, Escherichia coli, Staphylococcus aureus and Klebsiella Pneumoniae were isolated in significant numbers. Antibacterial susceptibility results were collected, an initial antibiogram was developed for 18 antibacterial agents with respect to 3gram-positive (+) and 1gram-negative (-) organisms. 90% of prescribers mentioned that the antibiogram was useful, and 76% of them adhered to the guidelines. 26% were not adhered due to the patient-related factors. In our study, we have used qualitative and quantitative evaluation of drug utilization (DUE) reports to understand the existing prescribing pattern of antibiotics and setting target organisms and antibacterials to develop the hospital antibiogram. Combining DUE studies and antibiogram development was helpful in implementing effective antibiotic policies for the hospital. Further, this study pattern will be continued on a yearly basis and focused on developing cumulative antibiograms to understand the changes in resistance pattern of antimicrobials and utilization of antibiotics in the hospital.

Point prevalence of antimicrobial prescriptions among inpatient in a tertiary level hospital in Nepal

Introduction: Inappropriate use of antimicrobials increases resistance, morbidity, and mortality. Accurate information on the use of antibiotics is crucial to address the problem of antibiotic overuse and resistance. The aim of this study is to explore the antibiotic prescription pattern at inpatient departments of Dhulikhel Hospital.&#x0D; Method: This prospective point prevalence study was conducted in five inpatient departments by making 25 visits between June 2018 and March 2019. Patient planned to be discharged on the day of visit was included in the study. The details of the patients who received at least one antimicrobial for at least one clinical treatment condition or prophylaxis during the hospital stay was recorded. The data on the antimicrobials received, diagnosis, therapeutic indication according to predefined lists, and markers of prescribing quality were recorded.&#x0D; Result: Out of 179 patients, 125 patients (69.8%) were prescribed one or more antibiotics. There was noticeable variation in prevalence of antibiotic prescription across the departments, ranging from 59.5%-78.9 %. The top three prescribed antibiotics were third generation cephalosporins 63 (38%), broad spectrum penicillin 49 (29.5%), and metronidazole 19 (11.4%). The patients received antibiotic for non-bacteriological proven infection 66 (52.8%) and only 8 (6.4%) patient received antibiotic for bacteriological proven infection. Culture and sensitivity testing were sent in 45(36%) patients and urine was the most frequent specimen&#x0D; Conclusion: Study concluded that there is need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital.

Antibiotic Prescribing Patterns in Paediatric Primary Care in Italy: Findings from 2012-2018.

Comprehensive data are needed to monitor antibiotic prescribing and inform stewardship. We aimed to evaluate the current antibiotic prescribing patterns, including treatment switching and prolongation, in the paediatric primary care setting in Italy. This database study assessed antibiotic prescriptions retrieved from Pedianet, a paediatric primary care database, from 1 January 2012 to 31 December 2018. Descriptive analyses were stratified by diagnosis class, calendar year, and children’s age. Generalized linear Poisson regression was used to assess variation in the prescriptions. In total, 505,927 antibiotic prescriptions were included. From 2012 to 2018, the number of antibiotics per child decreased significantly by 4% yearly from 0.79 in 2012 to 0.62 in 2018. Amoxicillin prescriptions decreased with increasing children’s age, while macrolides and third-generation cephalosporins had the opposite trend. Prescriptions were associated with a diagnosis of upper respiratory infection in 23% of cases, followed by pharyngitis (21%), bronchitis and bronchiolitis (12%), and acute otitis media (12%). Eight percent of treatment episodes were prolonged or switched class, mostly represented by co-amoxiclav, macrolides, and third-generation cephalosporins. Our findings report an overall decrease in antibiotic prescriptions, but pre-schoolers are still receiving more than one antibiotic yearly, and broad-spectrum antibiotics prescription rates remain the highest.

Antibiotic Prescribing Pattern at Primary Health Centers in Riyadh City, Saudi Arabia

PTB Reports,2021,7,3,102-106.DOI:10.5530/PTB.2021.7.17Published:December 2021Type:Research ArticleAuthors:Zainab Albahooth, Yousef Ahmed Alomi, Samia Zaben Almurshadi, Hind Nasser Altamimi, and Abdulaziz Hussain Alhussain Author(s) affiliations:Zainab Albahooth, Primary Healthcare Clinical Pharmacist, Pharmaceutical Care Department, Health Affairs in Riyadh City, Ministry of Heath, Riyadh, SAUDI ARABIA Yousef Ahmed Alomi*, BSc. Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, CDE, Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor and Data Analyst, Riyadh, SAUDI ARABIA. Samia Zaben Almurshadi, Primary Health Care Clinical Pharmacist, Pharmaceutical Care Department, Health Affairs in Riyadh City, Ministry of Health, Riyadh, SAUDI ARABIA. Hind Nasser Altamimi, Primary Health Care Quality Pharmacist, Pharmaceutical Care Department, Health Affairs in Riyadh City, Ministry of Health, Riyadh, SAUDI ARABIA. Abdulaziz Hussain Alhussain, Pharmacist, Pharmaceutical Care Department, Health Affairs in Riyadh City, Ministry of Health, Riyadh, SAUDI ARABIA. Abstract:Objectives: This study aims to identify antibiotic prescribing patterns in Riyadh’s Primary health care centers (PHCs). Methods: The study was a one-month cross-sectional medication prescription survey conducted at 25 PHCs in Riyadh. Results: A total of 18031 prescriptions were recorded in all 25 PHCs during the study period. Antibiotics were present in 3,879 (21.51%) of all prescriptions. The percentage of antibiotics prescribed varied from one primary care center to another; the highest documented percentage was 38.01 %. In comparison, the lowest proportion was discovered to be 10.56% of total antibiotics prescribed, with 3,131 (80.67 %) being bactericidal and 748 (19.3 %) being bacteriostatic. Capsules were the most commonly prescribed antibiotic dosage form 1,240 (32%), Amoxicillin was the antibiotic most frequently prescribed 1628 (42%), followed by a combination of Amoxicillin/Clavulanate 797 (20.5%). Of the total prescriptions, 2931 (75.6%) were written with generic names, while 948 (24.4%) were written with brand (trade) names. Amoxicillin was the most commonly prescribed antibiotic with a generic name (52.7%), while Amoxicillin/Clavulanate was the most usually prescribed antibiotic with the brand name “Augmentin” (69.4%). The frequency of antibiotics prescribed to patients who did not have a documented indication for Amoxicillin was 270. (6.9%). Conclusion: Antibiotics were prescribed in one-third of PHC prescriptions. Antimicrobial stewardship programs and training for healthcare professionals are needed at PHCs in Riyadh, Saudi Arabia. Keywords:Antibiotic, Pattern, Prescribing, Primary Health Centers, Riyadh City, Saudi Arabia.View:PDF (384.73 KB) PDF PDF Images Figure 1: The percentage of prescriptions containing antibiotics at PHCs.

Rational Prescription Pattern of Antibiotics: A Quantitative Analysis Based on Khwaja Yunus Ali Medical College and Hospital (KYAMCH), Sirajganj, Bangladesh

Antibiotics, alternatively known as antibacterial drugs, prevent or reduce the development of germs. A decade has been added to the life expectancy of human beings since the discovery of antibiotics. Antibiotic overuse can result in resistance to a wide spectrum of diseases and bacteria. Antibiotic utility is being jeopardized by the rise of resistance. There aren't enough innovative agents to deal with the problem of resistant strains. The current study targeted to highlight the current status of antibiotic use.The study was designed as a prescription-based survey where the medicines in prescriptions were checked containing antibiotics, whether the drugs were prescribed rationally or not. The study was conducted from February to July 2018 at Khwaja Yunus Ali Medical College and Hospital, Bangladesh. Patient’s data were collected through review of patient medical records and prepared questionnaires. 100 people were interviewed, and their prescriptions were captured as photos and then checked for rationality.The antibiotics are prescribed in the group of 10 to 30 years, 31 to 50 years and more than 50 years of age.The survey demonstrated that 46% of patients know about antibiotics partially, about 74% of patients fulfill their entire course of medication and the rest of the patients stop taking medication after feeling better. Only 21% of patients knew about antibiotic resistance, whereas 37% of patients only heard about antibiotic resistance. According to the age group from low to high, 92.9%, 91.67%, 86.36% prescriptions were rational; 2.4%, 2.78%, 4.55% prescriptions were contraindicated and 4.7%, 5.56%, 9.1% prescriptions where medicines interacted with other non-antibiotic drugs, respectively. The overall rational prescription is 91%, whereas 3% of prescriptions are contraindicated and 6% of prescriptions showed interaction between antibiotics and other drugs (non-antibiotics).The study concluded that lack of knowledge and awareness of patients and inaccurate prescription data by physicians are two key factors that contribute to irrational antibiotic usage.