ANTIBIOTIC PRESCRIBING PRACTICES AMONG HOSPITALIZED PATIENTS AT A NATIONAL ANTIMICROBIAL CONSUMPTION NETWORK SITE IN NORTH INDIA: A WHO POINT PREVALENCE SURVEY
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Keywords
Point Prevalence Survey (PPS), National Antimicrobial Consumption Network (NAC-NET), Antimicrobial resistance (AMR), AWaRe
Abstract
Background: Antimicrobial resistance (AMR) is a major global threat driven by inappropriate antibiotic use. Monitoring and analyzing antimicrobial prescribing practices and consumption patterns among hospitalized patients is essential for developing effective strategies to combat AMR.
Objective: This study aimed to evaluate antibiotic prescribing patterns among hospitalized patients at a National Antimicrobial Consumption Network (NAC-NET) site.
Methods: A cross-sectional study was conducted at GSVM Medical College, Kanpur, in February 2022, applying the standard guidelines described by the WHO Methodology for PPS on Antibiotic use among inpatients. Data on antimicrobial use, indications, routes, and WHO AWaRe classification were collected using structured forms and analyzed descriptively.
Results: Of 341 eligible inpatients, 93.3% were on at least one antibiotic, with a total of 586 antibiotics prescribed (average: 1.7 per patient). Injectable antibiotics accounted for 90.1% of use. Surgical prophylaxis (43%) and community-acquired infections (28%) were the most common indications. Only 11.9% of prescriptions included a stop/review date. Third-generation cephalosporins were the most frequently used (42%). The watch group antibiotics comprised 62.9% of prescriptions, while the Access group antibiotics were used in 31.8%—below the WHO target of ≥60%. Double coverage for Gram-negative organisms (28.3%) and double anaerobic coverage (14.1%) was frequently observed. Definitive therapy was rarely documented (0.3%).
Conclusion: The study identified a high rate of antibiotic use accompanied by inadequate adherence to stewardship principles. Findings underscore the need for institutional antibiotic guidelines, promotion of microbiological diagnostics, appropriate surgical prophylaxis, and increased use of Access group antibiotics to align with WHO recommendations.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Amit Kumar
Department of Pharmacology, Rajkiya Medical College, Jalaun (Orai), 285001, Uttar Pradesh, India.
Himanshu Sharma
Department of Pharmacology, GSVM Medical College, Kanpur, 208002, Uttar Pradesh, India.
Pooja Agrawal
Department of Pharmacology, GSVM Medical College, Kanpur, 208002, Uttar Pradesh, India.
Virendra Kushwaha
Department of Pharmacology, GSVM Medical College, Kanpur, 208002, Uttar Pradesh, India.