Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Surgery ward of a teaching hospital (original) (raw)
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Annals of clinical microbiology and antimicrobials, 2003
Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in Western Nepal. Excessive and inappropriate use of antibiotics contributes to the development of bacterial resistance. The parameter: Defined daily dose/100 bed-days, provides an estimate of consumption of drugs among hospital in-patients. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns. The study was carried out over a 3-month period (01.04.2002 to 30.06.2002) at the Manipal Teaching Hospital, Western Nepal. The median number of days of hospitalization and mean +/- SD cost of antibiotics prescribed during hospital stay were calculated. The use of antibiotics was classified for prophylaxis, bacteriologically proven infection or non-bacteriologically proven infection. Sensitivity patterns of the common organisms were determined. Defined dail...
Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in India. Excessive and inappropriate use of an antibiotic contributes to the development of bacterial resistance. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns. The study of prescribing patterns seeks to monitor, evaluate and suggest modifications in practitioners prescribing habits so as to make medical care rational and cost effective. Antibiotic resistance is becoming a problem in the internal medicine ward. Formulation of a policy for hospital antibiotic use and an educational programme especially for junior doctors is required.
International research journal of pharmacy, 2017
Wide reports in literatures from different parts of the world revealed that antibiotics resistance is a serious and growing phenol menon in contemporary medicine and has emerged as one of the pre-eminent public health concerns of the 21st century. The purpose of the study is to compare the pattern of antibiotic resistance and to determine whether irrational use of antibiotics is a reason for antibiotic resistance. It was a Prospective observational study conducted multi-disciplinary super specialty tertiary care hospital in South India. All inpatients with either sex admitted to General Medicine and surgery department, including age groups of 18-70 and whose medication profile contains a culture sensitivity test report were included in the study. The outcome of the study was as follows: Klebsiella (25.49%) was the major organism isolated during the Pilot scale study, followed by E. Coli (22.5%), Pseudomonas(12.7%) and Staph. Aureus (19.6%). Amoxicillin showed the best resistance in ...
RATIONALE OF ANTIBIOTIC PRESCRIPTION IN PATIENTS VISITING A TERTIARY CARE SOUTH INDIAN HOSPITAL
Asian Journal of Pharmaceutical and Clinical Research Journal, 2021
Objective: Antimicrobials are the class of drugs that are used irrationally in most cases leading to rise in instances of antimicrobial resistance altering the effect of such agents. Antimicrobial resistance has become a critical issue universally nerving the need to monitor the utilization pattern and rationality in prescribing of antibiotics. This helps in selection of most appropriate antibiotic for the specific patient and achieving the goals of the therapy. Methods: A prospective cross-sectional study with a sample size of 600 participants was conducted in department of general medicine of a tertiary care hospital. Inpatients prescribed with antibiotics were included in the study and their case sheets were reviewed to analyzing the prescribing pattern. The medication usage pattern was then assessed for rationality in prescribing was evaluated. The results obtained were statistically analyzed using SPSS Software. Results: It is noted that a more number of males participated and the greatest number of the patients were from the age group of 31-45. The diagnosis found in the majority of the patients was respiratory tract infection followed by others. On scrutinizing the prescriptions, it was noted that cephalosporins and penicillins were most often prescribed, and on an average single, antibiotic was frequently used with the preferred route of administration in most of the prescriptions being injection route. Though many of the antibiotics were prescribed empirically, it was observed that 59% of them were most appropriately dosed and maximum patients that are around 57% were cured from their illnesses. Conclusion: This study provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship programs. The culture and sensitivity testing suggested that the drug resistance was more for most commonly prescribed antibiotics in the hospital. Increased targeted prescribing based on sensitivity tests will bring down the high use of empiric broad-spectrum antibiotic use.
Antimicrobial resistance pattern in a tertiary care hospital: An observational study
Journal of basic and clinical pharmacy, 2013
Context: The number of organisms developing resistance to commonly used antibiotics is increasing among the various generations. The exact national scenario of antimicrobial resistance (AMR) is not known in India owing to the absence of a central monitoring agency. Aims: The aim of this study is to identify the group of organisms developing resistance, to know the classes of drugs against, which resistance has emerged and to assess the possible factors that can favor the development of AMR so that antibiotic policy can be formulated for the proper and effective use of antibiotics. Settings and Design: An observational study was conducted for a period of 1 year from August 2011 to July 2012 in a tertiary care hospital in Pondicherry. Subjects and Methods: Data regarding culture and sensitivity of the organisms isolated from different sources such as urine, blood, wound swab/pus, stool, sputum and tracheal aspirations were collected from the records of the Microbiology Department. Sample processing, identi ication of organisms to the genus and/or species level and antimicrobial sensitivity were carried out as per the Clinical and Laboratory Standards Institute guidelines on the 999 samples received. Results: Out of 999 samples, 125 (12.5%) showed signi icant growth of organisms exhibiting resistance to either single or multiple drugs. Out of 84 (67.2%) in-patients and 41 (32.8%) outpatient samples, Escherichia was the most common organism isolated with a total of 41 (32.8%), followed by Methicillin sensitive Staphylococcus aureus, 26 (20.8%), Klebsiella 25 (20%), Methicillin resistant Staphylococcus aureus 17 (13.6%), Pseudomonas 10 (8%), Proteus 2 (1.6%), 1 (0.8%) each of Citrobacter and Enterococci. Maximum resistance was observed with commonly used irst line antimicrobials such as co-trimoxazole, ampicillin, amoxicillin, amoxyclav, luoroquinolones, third generation cephalosporins and nalidixic acid. Least resistant or highly sensitive were amikacin, nitrofurantoin, gentamycin and doxycycline among the gram-negative bacteria. Macrolides, clindamycin, gentamycin, nitrofurantoin, vancomycin were the most sensitive antimicrobials against the gram-positive bacteria. Lack of knowledge on the consequences of inappropriate use of antibiotics was exhibited by 63% of subjects in our study. Conclusions: AMR was more with hospital acquired organisms and against commonly used antibiotics that are available since long period. Variation of resistance and sensitivity pattern with time and geographical location is identi ied. Periodic AMR monitoring and rotation of antibiotics are suggested to restrict further emergence of resistance.
Kathmandu University Medical Journal, 2022
Background Point prevalence survey (PPS) on antibiotic use developed by the WHO has already been used in many hospitals globally. Objective To obtain information on antibiotic prescribtion using point prevalence survey methodology in six private hospitals in the Kathmandu valley. Method This descriptive cross-sectional study was completed during 20 th July to 28 th July 2021 using point prevalence survey methodology. The study was conducted among inpatients admitted at or before 8:00 AM on the day of survey in various wards. Data was presented as frequencies and percentages. Result Maximum number of patients were above 60 years [34 (18.7%)]. Number of male and female participants were equal [91 (50%)]. Only one antibiotic was used in 81 patients (44.5%) followed by two antibiotics in 71 (39%) patients. Duration of prophylactic antibiotic use was one day in 66 (63.7%) patients. Blood, urine, sputum, and wound swabs were the common samples for culture. Cultures were positive for 17 (24.7%) samples. The common organisms isolated were E. Coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Ceftriaxone was the most used antibiotic. Drug and therapeutics, infection control committee and pharmacovigilance activities were present in 3/6 (50%) study sites. Antimicrobial stewardship was present in 3/6 (50%) and microbiological services was present in all hospitals. Antibiotic formulary and antibiotic guideline were present in 4/6 sites and facilities to audit or review surgical antibiotic prophylaxis choice in 2/6 (33.3%) sites, facility to monitor antibiotic use in 4/6 (66.6%) and cumulative antibiotic susceptibility reports in 2/6 (33.3%) study sites. Conclusion Ceftriaxone was the most used antibiotic. E. Coli, Pseudomonas aeruginosa and Klebsiella pneumonia were the commonly isolated organisms. Not all parameters for infrastructure, policy and practice and monitoring and feedback were present at the study sites.
Assessment of Antibiotic Use in a Secondary Care Referral Hospital of South India
IOSR Journal of Pharmacy and Biological Sciences, 2014
The emergence of antibiotic resistant bacteria is major problem throughout the world and rational use of antibiotics is therefore very important. Good infection control practice is a critical component for success of such programme. This six months prospective observational study was designed to evaluate the appropriateness of antibiotic use in a secondary care referral hospital of South India. The data of all in patients (n=100) were collected by obtaining a proper consent. Maximum of 52.78% patients had culture sensitivity test being done, which may taken as a indication for being rational. The results revealed that the purpose of antibiotics prescribed was for prophylaxis (15%), empirically (37%) and therapeutically 48%.In the study population (n=49), totally 110 antibiotics were prescribed, 71.88% on dual therapy and 28.12% were on three antibiotics and the mean number of antibiotics prescribed was 2.28. In the overall population, 61.65% were administrated intravenously and 39.35% of oral antibiotics The major organisms identified were E.coli (28.90%) and Amikacin had shown the highest sensitivity in E.coli (86.4%). Totally 31 drugs of antibacterials were listed in National List of Essential Medicine. Out of 31, 15 antibacterials were prescribed in study population.
Clinical Medicine Netprints, 2002
Background: Inappropriate use of antimicrobials is of special importance in the intensive treatment unit because of the large number of drugs prescribed, the chance for drug errors, and the likelihood of development of drug resistance. Methods: A total of 297 records of patients admitted to the intensive treatment unit of the Manipal teaching hospital, a tertiary care hospital in Pokhara, western Nepal, were studied to determine the prescribing frequency and rationality of use of antimicrobials. Patient outcome, duration of stay in the intensive treatment unit, and the age and sex distribution of the patients were also studied. Results: Mean 6 SD drugs per patient was 3.4 6 1.8. About half (50.2%) of the patients received an antimicrobial; 84.6% of the antimicrobials were used without obtaining bacteriologic evidence of infection. The commonest organisms isolated on culture were Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus pneumoniae, and Staphylococcus aureus. A total of 28.9% of the antimicrobials were prescribed for lower respiratory tract infections on the basis of the putative site of infection; 61.9% of the antimicrobials were prescribed by the parenteral route and mainly the older generation of antimicrobials were used. In 39 of the 149 patients prescribed an antimicrobial, the use was irrational. Conclusions: Prescriber education to improve prescribing patterns and regular auditing of antimicrobial prescriptions to prevent their inappropriate use and unnecessary cost to the patients are required. The high percentage of inappropriate use of antimicrobials raises concerns about the development and spread of drug resistance, which must be addressed.