Assessment of antimicrobial use among patients admitted to a tertiary care hospital: A prospective observational study using World Health Organization AWaRe and Indian Council of Medical Research guidelines
Abstract
Background: Antimicrobial resistance has emerged as a global challenge to human health, primarily due to inappropriate use. The ICMR reports revealed that there is sustained rise of AMR in India.
Objective: The objective of this study was to evaluate the prescribing pattern of antimicrobials and rationality of empiric antimicrobial use in a tertiary care hospital.
Method: A prospective observational study, approved by the Institutional Ethical Committee (IEC) was conducted for a period of one year from July 2023 to June 2024 among the admitted patients of the hospital. The prescribing pattern was assessed in accordance with AWaRe classification and prescribing indicators by the World Health Organization. Rational use of empiric therapy was assessed as per the ICMR 2022 guidelines.
Results: A total of 653 antimicrobials were prescribed to 289 patients and maximum antimicrobials were from Watch category (55.7%), followed by Access (40.4%), and Reserve category (2.3%). The respiratory tract infection was the most common indication to start empiric antimicrobial therapy. The empiric therapy was appropriate for 80.3% patients as per the ICMR guidelines. The observed deviations were the empiric use of amikacin for bone & joint infection, duplicate beta lactam therapy, 3rd generation cephalosporins for uncomplicated urinary tract infection, the use of Reserve antibiotic-linezolid, and the use of piperacillin/tazobactam for sepsis patients.
Conclusion: There is a need to strengthen…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 289 participants or records.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.