A Descriptive Study on Antimicrobial Drugs Usage in a Tertiary Care Hospital

Background: Across the globe, the emergence of resistant organisms is alarmingly high. Antimicrobials are one of the most common groups of drugs prescribed in hospitals. In addition to poor patient compliance, irrational and inappropriate antimicrobial prescription is a major contributor to the development of drug resistance. It is critical to raise antimicrobial resistance awareness among physicians and patients. Encouraging physicians/surgeons to participate in infectious disease control training programmes on a regular basis would be beneficial in combating resistant organisms, also known as super bugs.

Objectives: To assess the pattern of antimicrobial usage in a tertiary care hospital, to determine whether antimicrobials are prescribed judiciously.

Methods: To determine the current antimicrobial prescribing practises at Tagore Medical College Hospital, a retrospective study was conducted. A randomised sample of 100 inpatient case sheets of General Medicine, OBG, General Surgery, Paediatrics, Chest Medicine, Skin, and ENT from Medical Records Department was analysed with respect to oral and parenteral (IV) administration of antimicrobials.

Results: Males made up 53% of the participants in this study, while females made up 47%. Majority of patients were middle aged (17-60yrs). For 100 inpatients, a total of 16 antimicrobials were prescribed. Metronidazole and Ciprofloxacin were the most commonly used antibiotics. The treatment lasted a minimum of three days, a maximum of thirteen days, and a mean of 5.5 days. Because the patients were inpatients, the most common route of antimicrobial administration was parenteral. The Parenteral (IV) drugs were Metronidazole (52%), Ciprofloxacin (42%), Cefotaxime (27%), Amikacin (7%), Ceftriaxone (7%).Among 100 prescriptions, 63% were empirical prescriptions, 12% were directed and 25% were targeted prescriptions.

Conclusions: Metronidazole and Ciprofloxacin were the most commonly used antimicrobials, and the condition for which the antimicrobials were commonly used was acute gastroenteritis. When compared to empirical prescriptions, the proportion of targeted prescriptions was low. Antimicrobials must be prescribed rationally in accordance with antibiotic policy.