Abstract

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Abstract

A Cross Sectional Study of Antibiotic Usage in a Tertiary Care Hospital and Health Center in a North Maharashtra District

Author:Shyam V Ashtekar, Sanjukta V Shenoy, Prerana S Gosavi, Ratna S Ashtekar

Keywords:Antibiotics, prescriptions, AMR guidelines, GARP

Type:Original Article

Abstract:"Introduction: Appropriate use of antibiotics is important for (a) Better therapeutic results (b) Saving costs (c) Minimize resistance to antibiotics. This is a descriptive cross-sectional study of pre-scriptions in a tertiary hospital and health center. Objective was to evaluate antibiotic usage in a teaching institute. Methodology: For a sample size of 220, 256 prescriptions from IPD and OPD, containing any antimicrobial, at the pharmacy and another 240 prescriptions from the peripheral Health Centre were collected over a fortnight in 2018. Prescriber identity was concealed and protected. Prescriptions were assessed by two independent raters based on the AMR National Guidelines on antibiotics. Rater 1 and Rater2 had fair agreement (quadratic kappa 0.3348, 95%CI 0.2207-0.4489). Data were compiled and analyzed on excel and EPI info. Results: Hospital pool yielded 203 medical and 53 surgical cases, of which 60% prescriptions were rated appropriate, 35% borderline and 5% un-acceptable. Health center data (n=240) showed 89% had no diagnosis. Amoxicillin+Clavulinic acid, ceftriaxone, azithromycin, Ofloxacin topped the hospital usage, while Amox+CA and Cefixime topped the health center usage. Conclusions: Hospital prescriptions nearly conformed to guidelines, the Health center prescribing called for adherence to protocols. Cost –reducing options and minimizing resistance to higher antibiotics."