Rational Use and Prescribing Pattern of Antibiotics in Community Patients with Lower Respiratory Tract Infections: A Prospective Observational Study at a Tertiary Care Teaching Hospital, Jaipur
Abstract
Background: Lower respiratory tract infections (LRTIs) are a leading driver of antibiotic consumption and antimicrobial resistance (AMR) globally. In India, irrational prescribing practices compound an already critical resistance burden. Pharmacoepidemiological studies are essential to understand prevailing prescribing behaviours and guide stewardship interventions. • Objectives: To assess the prescribing pattern and rationality of antibiotic use in community LRTI patients at NIMS University Hospital, Jaipur, against WHO/INRUD core drug-use indicators, IDSA/BTS/GOLD clinical guidelines, and the WHO AWaRe (Access, Watch, Reserve) antibiotic classification. • Methods: A prospective, cross-sectional, observational drug utilisation study over 12 months (January– December 2023) at NIMS Medical College & Hospital. 250 adult LRTI patients enrolled by consecutive sampling. Prescriptions were evaluated for rationality; ADRs monitored by the Naranjo causality algorithm. • Results: Males predominated (64.8%); mean age 44.6 ± 16.3 years. Acute bronchitis (32.8%) and CAP (27.2%) were most common. Amoxicillin-clavulanate (25.0%), azithromycin (17.3%), and levofloxacin (13.5%) led 312 prescriptions. Guideline-concordant selection: 84.8%. Culture-guided prescribing: 15.2%. Generic-name prescribing: 58.4%. Injection encounters: 22%. Mean drugs/prescription: 3.2 ± 0.8. ADRs in 62 patients (24.8%); 45.2% were potentially preventable. • Conclusions: Antibiotic selection is largely…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 250 participants or records.
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