Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Surgery ward of a teaching hospital
Kevin D Bosco, Inkoti Hima Bindu, Dr. R Ramesh, Dr. K Saravanan
Background: The widespread and often inappropriate use of antimicrobial agents is the single most important cause of the emergence of drug resistance, both in the community and hospital settings. Theirrational prescribing of medicine results in serious morbidity andmortality and also lead to reduction in the quality of treatment; thereby causing wastage of resources, increased treatment cost, increased risk for adverse drug reaction, and emergence of resistance. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and common organisms isolated including their antibiotic sensitivity patterns so as to provide appropriate antimicrobial therapy to reduce the risk of proven or suspected bacterial infections and to prevent the emergence of resistant bacteria and to prevent the misuse of antimicrobials to decrease the cost involved and the emergence of antibiotic resistant bacteria. Methods: This study was carried out over a 6 month period with the aim of identifying prescriptionpattern of antibiotics and evaluating the rational use of antibiotics in accordance with WHO prescribing indicators. 60 prescriptions were examined from the inpatient department of Surgery wards of Rajah Muthiah Medical College and Hospital (RMMCH), Chidambaram. The wards were visited twice a week. Each prescription was followed till the discharge date. The prescribing details from each prescription were recorded and the drug use patterns of antibiotics were examined. The antimicrobial sensitivity patterns of common organisms were determined and the suspected adverse drug events with antibiotic therapy during the study period were recorded. The data were analysed as per the WHO core drug use indicators. Results: The result shows that 60 patients were prescribed antibiotics out of which 44 patients were male. 10 antibiotics were mostly prescribed and the most common ones were cefotaxime, metronidazole, ciprofloxacin, ceftriaxone and amikacin. Culture sensitivity tests were carried out in 30 patients. The common organisms isolated were Escherichia coli, Staphylococcus aureus and Methicillin Resistant Staphylococcus aureus. Conclusions: Irrational use of drugs can lead to ineffective and unsafe treatment and exacerbation and prolongation of illness, distress and harm to the patients. Hence prescription audit is necessary and the Clinical Pharmacist interventional programs should focus on promoting infectious control with rational antibiotic prescription aimed at minimizing the future emergence of bacterial resistance. Multi-faceted interventions are suggested at many levels for the benefitsof the community in the form of continued medical educational programs, consumer awareness and policy formation for hospital antibiotic use.