A Study and Report on Assessment of Antibiotic Prescribing Patterns and Drug Resistance Among Various Infectious Diseases in Hospital

Mekkanti Manasa Rekha; Greeshma Cherian; Rinku Mathappana

doi:10.37591/rrjomst.v10i2.2684

Abstract

Antimicrobial resistance remains the biggest cause of death worldwide. According to the World Health Organization, the age standardized mortality due to infectious diseases in India in 2008 was 377 per 100,000 persons, which is considered as highest in South Asia. This has led to the increased prescribing of antibiotics even at unnecessary conditions, which increased the rate of inappropriate prescribing of antibiotics, which in turn resulted in the emergence of antibiotic resistance. Antibiotic resistance can be controlled by monitoring and implementing strict rules and regulations for the appropriate prescribing of antibiotics among the prescribers and by reducing the overuse of antibiotics among patients by providing patient counseling. The main aim of the present study was to study and report on assessment of antibiotic prescribing patterns and drug resistance among various infectious diseases in the Department of General Medicine, Pediatric, Surgical and Obstetrics/Gynecology at ESI Hospital, Indiranagar, Bangalore, Karnataka, India. Data were collected through treatment chart review and medication history interview maintained in the nursing station of General Medicine, Surgical and Gynecology departments, following the pre-tested structured questionnaire and standard antibiotic indicator generated by the World Health Organization. The patient's medication information was collected through questionnaire and the antibiotic resistance through laboratory reports. Out of 200 prescriptions analyzed, 120 prescriptions comprised of inappropriately prescribed antibiotics and it was found that 68 (56.6%) prescriptions contained multiple prescribing of antibiotics, in which 58.8% was repetition of drug, 41.17% was over prescribing of antibiotics, 18.33% was due to inappropriate choice of antibiotics as a result of uncertain diagnosis, 8.33% was due to wrong duration and frequency, 15% was due to pressure from the patients and 1.66% was due to prescription by inexperienced prescribers or due to decision fatigue among the doctors. It was found that out of 120 prescriptions analyzed 57 prescriptions showed the presence of antimicrobial resistance. This inappropriate pattern of prescribing or administering antibiotics has led to 47.5% of development of resistance against the frequently used antibiotics to treat infections. The present study clearly indicated that there is an urgent need of clinical pharmacist interventions and services in promotion of rational prescribing of antibiotics, by educating, organizing, conducting and participating in programmes on the rational use of antibiotics, by conducting sensitivity testing before antibiotic prescribing and by encouraging the implementation of Antimicrobial stewardship programmes for the appropriate use of antibiotics.

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