scholarly journals Antibiotic prescribing among inpatients with infectious and non-infectious indications in obstetrics and gynecology departments at two tertiary care hospitals in Central India

2019 ◽  
Author(s):  
Anna Machowska ◽  
Kristoffer Landstedt ◽  
Cecilia StålsbyLundborg ◽  
Megha Sharma
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infection ◽  
Tertiary Care ◽  
Central India ◽  
Prescribing Patterns ◽  
Fixed Dose ◽  
Obstetrics And Gynecology ◽  
Antibiotic Prescribing ◽  
Surgical Indications ◽  
Tertiary Care Hospitals

Abstract Background: Patients in departments such as obstetrics and gynecology (OBGY) are at high risk of life-threatening infections, thus are prescribed antibiotics extensively. Use of antibiotics leads to increasing antibiotic resistance. Antibiotic surveillance is one of the cornerstones to combat antibiotic resistance. However, hospital-based, department specific surveillance data of prescribed antibiotics are scarce especially in low- and middle-income countries. Aim: To describe and compare antibiotic prescribing patterns among the inpatients at OBGY departments of two tertiary care hospitals, one teaching (TH) and one non-teaching (NTH) in Central India. Methods: Data of all inpatients was collected manually for three years and analyzed using demographics, length of hospital stay, diagnoses and prescribed antibiotics including dose, duration, and frequency and defined daily dose per 1000 inpatients were calculated. The patients were divided into, infectious and non-infectious categories and further into surgical, non-surgical and possible surgical indications. The data was coded based on the Anatomical Therapeutic Chemical classification system and the International Classification of Disease system version-10. Results: Of the total 5558 admitted patients, 2044 (81%) in the TH and 2567 (85%) in the NTH received antibiotic treatment (p<0.001). In both hospitals, a majority of the patients with surgical indications were prescribed antibiotics (87% to 100%). Prescribing of the fixed-dose combinations of antibiotics (FDCs) and use of brand names was more common at the NTH then at the TH. A majority of the inpatients who neither had surgery nor had any confirmed bacterial infection also received antibiotic prescriptions (TH-71%, NTH-75%). Overall, higher DDD/1000 patients were prescribed in the TH compared to the NTH in both categories. Conclusions: More frequent prescribing of broad-spectrum antibiotics including FDCs and higher brand-name prescribing at the NTH compared to the TH is a point of concern. Antibiotics prescribed to the inpatients having non-bacterial infection indications is another point of concern and requires urgent action. Investigation of underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve the prescribing of antibiotics.

scholarly journals Antibiotic prescribing among inpatients with infectious and non-infectious indications in obstetrics and gynaecology departments at two tertiary care hospitals in Central India

2019 ◽  
Author(s):  
Anna Machowska ◽  
Kristoffer Landstedt ◽  
Cecilia Stålsby Lundborg ◽  
Megha Sharma
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infection ◽  
Tertiary Care ◽  
Central India ◽  
Prescribing Patterns ◽  
Fixed Dose ◽  
Antibiotic Prescribing ◽  
Surgical Indications ◽  
Obstetrics And Gynaecology ◽  
Tertiary Care Hospitals

Abstract Background : Patients in departments such as obstetrics and gynaecology (OBGY) are at high risk of life-threatening infections, thus are prescribed antibiotics extensively. Use of antibiotics leads to increasing antibiotic resistance. Antibiotic surveillance is one of the cornerstones to combat antibiotic resistance. However, hospital-based, department specific surveillance data of prescribed antibiotics are scarce, especially in low- and middle-income countries. Aim: To describe and compare antibiotic prescribing patterns among the inpatients at OBGY departments of two tertiary care hospitals, one teaching (TH) and one non-teaching (NTH), in Central India. Methods: Data of all inpatients was collected manually for three years and analysed using demographics, length of hospital stay, diagnoses and prescribed antibiotics including dose, duration, and frequency and defined daily dose per 1000 inpatients were calculated. The patients were divided into, infectious and non-infectious categories and further into surgical, non-surgical and possible surgical indications. The data was coded based on the Anatomical Therapeutic Chemical classification system and the International Classification of Disease system version-10. Results: Of the total 5558 admitted patients, 2044 (81%) in the TH and 2567 (85%) in the NTH received antibiotic treatment (p<0.001). In both hospitals, a majority of the patients with surgical indications were prescribed antibiotics (87% to 100%). Prescribing of the fixed-dose combinations of antibiotics (FDCs) and use of brand names was more common at the NTH then at the TH. A majority of the inpatients who neither had surgery nor had any confirmed bacterial infection also received antibiotic prescriptions (TH-71%, NTH-75%). Overall, higher DDD/1000 patients were prescribed in the TH compared to the NTH in both categories. Conclusions: More frequent prescribing of broad-spectrum antibiotics, including FDCs and higher brand-name prescribing at the NTH compared to the TH, is a point of concern. Antibiotics prescribed to the inpatients having non-bacterial infection indications is another point of concern and requires urgent action. Investigation of underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve the prescribing of antibiotics.

scholarly journals Antibiotic prescribing among inpatients with infectious and non-infectious indications in obstetrics and gynaecology departments at two tertiary care hospitals in Central India

2020 ◽  
Author(s):  
Anna Machowska ◽  
Kristoffer Landstedt ◽  
Cecilia Stålsby Lundborg ◽  
Megha Sharma
Keyword(s):  
Hospital Stay ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Central India ◽  
Fixed Dose ◽  
Antibiotic Prescribing ◽  
Prescription Data ◽  
Surgical Indications ◽  
Obstetrics And Gynaecology ◽  
Tertiary Care Hospitals

Abstract Background: Patients in obstetrics and gynaecology (OBGY) departments are at high risk of life-threatening infection, thus prescribed antibiotics extensively. The use of antibiotics leads to increasing antibiotic resistance (ABR). Antibiotic surveillance is one of the cornerstones to combat ABR. However, surveillance of, department specific antibiotic prescription data is rarely performed, especially in low- and middle-income countries. Aim: To describe and compare antibiotic prescription patterns among the inpatients at OBGY departments of two tertiary care hospitals, one teaching (TH) and one non-teaching (NTH), in Central India. Methods: A prospective study was conducted for three years using. Demographics, length of hospital stay, diagnoses and prescribed antibiotics including dose, duration and frequency were recorded for all inpatients during their hospital stay. The patients were divided into, infectious and non-infectious diagnosis categories and further into surgical, non-surgical and possible surgical indications using the International Classification of Disease system version-10. Results: A total of 5558 patients were included in the study; 2044 (81%) in the TH and 2567 (85%) in the NTH received antibiotics (p<0.001). A majority of the patients with surgical indications were prescribed antibiotics (TH-87%, NTH-100%). Prescribing of the fixed-dose combinations (FDCs) of antibiotics and use of trade names were more common at the NTH. Most of the inpatients who had neither surgery nor any confirmed bacterial infection received antibiotics (TH-71% and NTH-75%). Overall, higher DDD/1000 patients were prescribed in the TH in both categories. Conclusions: High antibiotic prescribing for the inpatients having no infection indications in both hospitals, as well as frequent prescribing of trade-name, broad-spectrum antibiotics, including the FDCs in the NTH than the TH, are points of concern. Investigation of the underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve the antibiotic prescribing practice.

scholarly journals Antibiotic Prescribing to Patients with Infectious and Non-Infectious Indications Admitted to Obstetrics and Gynaecology Departments in Two Tertiary Care Hospitals in Central India

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 464
Author(s):  
Anna Machowska ◽  
Kristoffer Landstedt ◽  
Cecilia Stålsby Lundborg ◽  
Megha Sharma
Keyword(s):  
Broad Spectrum ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Central India ◽  
Fixed Dose ◽  
Antibiotic Prescribing ◽  
Middle Income ◽  
Obstetrics And Gynaecology ◽  
Defined Daily Doses ◽  
Tertiary Care Hospitals

Background: Patients admitted to obstetrics and gynaecology (OBGY) departments are at high risk of infections and subsequent antibiotic prescribing, which may contribute to antibiotic resistance (ABR). Although antibiotic surveillance is one of the cornerstones to combat ABR, it is rarely performed in low- and middle-income countries. Aim: To describe and compare antibiotic prescription patterns among the inpatients in OBGY departments of two tertiary care hospitals, one teaching (TH) and one nonteaching (NTH), in Central India. Methods: Data on patients’ demographics, diagnoses and prescribed antibiotics were collected prospectively for three years. Patients were divided into two categories- infectious and non-infectious diagnosis and were further divided into three groups: surgical, nonsurgical and possible-surgical indications. The data was coded based on the Anatomical Therapeutic Chemical classification system, and the International Classification of Disease system version-10 and Defined Daily Doses (DDDs) were calculated per 1000 patients. Results: In total, 5558 patients were included in the study, of those, 81% in the TH and 85% in the NTH received antibiotics (p < 0.001). Antibiotics were prescribed frequently to the inpatients in the nonsurgical group without any documented bacterial infection (TH-71%; NTH-75%). Prescribing of broad-spectrum, fixed-dose combinations (FDCs) of antibiotics was more common in both categories in the NTH than in the TH. Overall, higher DDD/1000 patients were prescribed in the TH in both categories. Conclusions: Antibiotics were frequently prescribed to the patients with no documented infectious indications. Misprescribing of the broad-spectrum FDCs of antibiotics and unindicated prescribing of antibiotics point towards threat of ABR and needs urgent action. Antibiotics prescribed to the inpatients having nonbacterial infection indications is another point of concern that requires action. Investigation of underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve antibiotic prescribing practice.

scholarly journals Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245902
Author(s):  
Kristina Skender ◽  
Vivek Singh ◽  
Cecilia Stalsby-Lundborg ◽  
Megha Sharma
Keyword(s):  
Design Patterns ◽  
Central India ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Defined Daily Doses

Background Frequent antibiotic prescribing in departments with high infection risk like orthopedics prominently contributes to the global increase of antibiotic resistance. However, few studies present antibiotic prescribing patterns and trends among orthopedic inpatients. Aim To compare and present the patterns and trends of antibiotic prescription over 10 years for orthopedic inpatients in a teaching (TH) and a non-teaching hospital (NTH) in Central India. Methods Data from orthopedic inpatients (TH-6446; NTH-4397) were collected using a prospective cross-sectional study design. Patterns were compared based on the indications and corresponding antibiotic treatments, mean Defined Daily Doses (DDD)/1000 patient-days, adherence to the National List of Essential Medicines India (NLEMI) and the World Health Organization Model List of Essential Medicines (WHOMLEM). Antibiotic prescriptions were analyzed separately for the operated and the non-operated inpatients. Linear regression was used to analyze the time trends of antibiotic prescribing; in total through DDD/1000 patient-days and by antibiotic groups. Results Third generation cephalosporins were the most prescribed antibiotic class (TH-39%; NTH-65%) and fractures were the most common indications (TH-48%; NTH-48%). Majority of the operated inpatients (TH-99%; NTH-97%) were prescribed pre-operative prophylactic antibiotics. The non-operated inpatients were also prescribed antibiotics (TH-40%; NTH-75%), although few of them had infectious diagnoses (TH-8%; NTH-14%). Adherence to the NLEMI was lower (TH-31%; NTH-34%) than adherence to the WHOMLEM (TH-65%; NTH-62%) in both hospitals. Mean DDD/1000 patient-days was 16 times higher in the TH (2658) compared to the NTH (162). Total antibiotic prescribing increased over 10 years (TH-β = 3.23; NTH-β = 1.02). Conclusion Substantial number of inpatients were prescribed antibiotics without clear infectious indications. Adherence to the NLEMI and the WHOMLEM was low in both hospitals. Antibiotic use increased in both hospitals over 10 years and was higher in the TH than in the NTH. The need for developing and implementing local antibiotic prescribing guidelines is emphasized.

scholarly journals Antimicrobial prescribing patterns in surgical inpatient of tertiary care hospital in Eastern India

2019 ◽  
Vol 8 (8) ◽  
pp. 1902
Author(s):  
Sumit Kumar Gupta ◽  
Siddhartha Ghosh
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Beta Lactam ◽  
Cross Sectional ◽  
Before And After ◽  
Surgery Department

Background: Antimicrobials form the cornerstone of prescriptions for treating infection. Surgical management cannot be possible without the use of antibiotics. Severity of infection, suspected spectrum of organisms and their sensitivity, co-morbidities of the patient, route of antibiotic administration are the important parameter to consider before selecting antibiotic.Methods: Cross-sectional, hospital based, descriptive study was conducted in the ward of Surgery Department of IQ City Medical college, Durgapur over a period of 1 year. The relevant information was entered into the pretested preformats (containing name, age, sex, diagnosis, ongoing treatment as recorded from patients’ prescription slips or CRFs) and analyzed. Necessary permission was granted by the Institutional Ethical Committee and written informed consent was obtained from the patients prior to collecting their prescription slips/CRF.Results: Commonest cause of hospitalization was cholelithiasis (318 (32.7%)). Antimicrobials were the most commonly prescribed drugs (1626 (31.6%)). Single antibiotic prescribing frequency are similar to two antibiotic prescribing (both 44%). Piperacillin+Tazobactum combination most commonly prescribe antibiotic.Conclusions: Beta lactam antibiotic specifically Piperacillin (ATC class: J01D) were the most commonly prescribed antibiotic agents both before and after surgical procedures.

scholarly journals Prescribing patterns of cardiovascular drugs in cardiology outpatient department in a tertiary care hospital in Western Odisha

2020 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ayan Roy ◽  
Nayan Kumar Patel
Keyword(s):  
Drug Utilization ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiovascular Drugs ◽  
Prescribing Patterns ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Clinical Practices ◽  
Common Diagnosis

Background: Cardiovascular morbidity plays a villainous role globally as well as countries like India. Additionally, irrational prescription incurs greater damage to health and wellbeing. Drug utilization studies scrutinize the appropriateness of treatment and provide favorable feedbacks to strengthen clinical practices. The objective of the study was to describe treatment practices in cardiology outpatient and drug utilization pattern using core prescribing indicators by World Health Organization (WHO).Methods: A cross-sectional, observational study of 4-month duration was undertaken for cardiology Outdoor patients at a tertiary care hospital. 615 prescriptions were screened and analyzed.Results: Males (59.84%) were more in number than females (40.16%). Average number of the prescribed drugs per patient were 4.32±2.7 and (3.73±1.1 for cardiovascular drugs). Generic prescription was 60.98%. Percentage encounters with antibiotics 4.11, injectables 2.92%, fixed-dose combinations (FDCs) (11.8%) were documented. Drugs from the National List of Essential Medicines were 75.89%. The most common diagnosis was ischemic heart disease (68.29%). Hypolipidemics (78.25%) followed by antiplatelets (71.14%) were toppers in cardiovascular drug. Antiulcer drugs (PPI/Antacids) comprised 58.54% of total prescriptions.Conclusions: Less adherence to EDL, less generic prescriptions, use of FDC are major shortcomings. Areas to further rationalization like optimal use of evidence based medication like beta-blockers, newer anticoagulants/anti-platelet agents and newer anti-anginal agents are identified.

scholarly journals Infection surveillance analysis of catheter associated urinary tract infections in obstetrics and gynecology department of a tertiary care hospital of Central India

2017 ◽  
Vol 7 (1) ◽  
pp. 215
Author(s):  
Mudita Jain ◽  
Rituja Kaushal ◽  
Malini Bharadwaj
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Central India ◽  
Integrated Approach ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Stewardship Program ◽  
Tract Infections ◽  
A Prospective Study

Background: The prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. As device related hospital acquired infections are imposing major threats in surgical realm of medical sciences, this study was undertaken with the objective to asses catheter related urinary tract infections magnitude.Methods: This study was undertaken in a tertiary care setting of Obstetrics and Gynecology Department of a Central Indian city. It is a prospective study conducted over a full year span from April 2016 to March 2017.Results: CAUTI was calculated as 8.95 per thousand catheter days for the whole study period. Out of the total number of 18 urinary isolates, E. Coli and Enterococcus species were more commonly implicated.Conclusions: In order to restraint the enigma, a multidisciplinary integrated approach including periodic training sessions for all health care workers based on bundled care interventions supervisory checklists etc. is needed. Aseptic techniques along with IDSA (Infectious disease society of America) guidelines/other similar protocols are recommended to bring down overall prevalence. Prudent use of antibiotics is to be accorded as per antibiotic stewardship program to combat drug resistance.

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