Appraisal of Antibiotic Utilization in Various Departments of a Tertiary Care Hospital: A Retrospective Study

Abstract

The study aimed to ascertain the use and prescribing pattern of antibiotics in hospitalized patients in different departments of a tertiary care hospital. A retrospective cross-sectional observational study was performed in Guntur government hospital having 1200 bed capacity for a time period of six months from November 2020 to April 2021 on a total of 1036 patients from which 629 patients were considered based on the inclusion criteria. Of the total patients 340 (54%) were male and 289 (46%) were female and the most prevalent disease during our study period  in Cardiology department was Ischemic stroke 33 (50%), followed by Hemorrhagic stroke 13(21%), Gastric ulcer and Gastroenteritis 34(50%) in Gastroenterology department, Hepatocyte growth factor deficiency 31(23%) followed by Acute febrile illness 22(16%) in General medicine department, and CKD 53(50%) followed by Acute kidney injury and pyelonephritis 18(17%) each in Nephrology department and in Pediatric department the most prevalent condition during our study period was Respiratory tract infection 42(26%), followed by Dog bite conditions with 31(19%) patients. During our study period the most prevalently used antibiotics were Ceftriaxone 292 (34.6%), followed by Metronidazole 150 (17.7%) and the least prevalent antibiotic used was Meropenem 6 (0.7%). The most prevalently used antibiotics in Cardiology department during our study were Ceftriaxone 42(51%), Ceftriaxone 71(48%) in Nephrology department, Metronidazole 30(30%) in Gastroenterology department, Ceftriaxone 109(46%) in General medicine department, Amoxicillin & Clavulanic acid 66(21%) in Pediatric department. During our study period, total antibiotics prescribed were broad-spectrum antibiotics. The mean number of antibiotics per prescription was 1.4. By this our study concludes that, lack of consciousness on the use of medicine especially antibiotic is the major cause of inappropriate use. Education and research on antimicrobial resistance, and regulation of use of antimicrobials in hospitals as well as in the community should be provided. This study states that development of clinical pharmacist services is also necessary to improve the rational prescribing of drugs mostly antibiotics.