A multicentric, prospective, observational antibacterial utilization study in Indian tertiary referral centers
Jigeeshu V. Divatia, Nitin Mali, Siddharth P. Deshpande, Niteen D. Karnik, Nithya J. Gogtay, Renuka P. Munshi, Sanjay C. Wagle, Kannan Sridharan
Antibacterial resistance, antibacterials, indicators, medical intensive care unit, public and private hospitals
Citation Information :
Divatia JV, Mali N, Deshpande SP, Karnik ND, Gogtay NJ, Munshi RP, Wagle SC, Sridharan K. A multicentric, prospective, observational antibacterial utilization study in Indian tertiary referral centers. Indian J Crit Care Med 2018; 22 (10):723-729.
Rationale: Antibacterials are largely prescribed to the intensive care unit (ICU) patients due to high prevalence of infections. However, appropriate use of antibacterials is imperative; since the misuse of antibacterials increases antibacterial resistance and ultimately, it has negative impact on health care and economic system. Hence, continuous antibacterials prescription assessments are very important to judge and improve prescription patterns. The present work was carried out at public and private hospitals to assess the differences in antibacterial prescribing pattern.
Methods: The present study was conducted at three public and two private hospitals over the period of 14 months. Demographic and drug use details were captured daily from patients admitted to medical ICUs to assess the World Health Organization indicators.
Results: A total of 700 patients were enrolled across the five centers (140 per center), among them 424 were male and 276 were female. Average number of drugs and antibacterials prescribed at public hospitals are significantly higher than the private hospital. However, percentage of antibacterial agents prescribed at public hospitals was significantly lower than the private hospitals (P = 0.0381). Private hospitals had significantly lower percentage of antibacterial agents prescribed by generic name (P < 0.0001). Differences in change of antibacterial agents required were not statistically significantly different (P = 0.1888); however, significant difference was observed in percentage of patients who received antibacterial treatment as per sensitivity pattern (P = 0.0385) between public and private hospitals. Significantly higher mortality was observed in public hospitals compared to private hospitals (<0.0001).
Conclusions: More generic prescriptions and more number of prescriptions as per the sensitivity pattern are required at each public and private hospital.
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