Assessment of antimicrobial utilization pattern using World Health Organization indicators in a tertiary care hospital: A cross-sectional study

Objectives: The aim of the study was to analyze the antimicrobial utilization pattern using the World Health Organization (WHO) indicators with the ultimate goal of ensuring rational drug use to evaluate the policies and procedures in the hospital for the appropriate use of antimicrobials using hospital indicators and prescribing indicators. Materials and Methods: A prospective, cross-sectional study was conducted in a tertiary care hospital in the southern part of India, where data from the pharmacy section and 125 patient records each from general medicine, surgery, and intensive care unit patients were taken. Antimicrobials' prescription and utilization patterns in tertiary care were analyzed using the WHO hospital and prescribing indicators. Results: The hospital indicators were up to the expected level of the WHO standards with standard treatment guidelines (STGs), hospital formulary, and the critical list of antimicrobials available on the assessment day. None of the antibiotics were out of stock during the study period. Around 55.4% of admitted patients were prescribed antibiotics in the prescribing indicators, with the average number of antibiotics per patient being 1.591. With almost 99.7% of antibiotics are prescribed from the hospital formulary list and around 3003.7 INR as the average cost per hospitalization. The average duration of treatment was 4.96 days, with 74.3% of pneumonia patients treated according to the STG. The antimicrobials prescribed with the generic name were only 17.58%. Conclusions: The prescribing pattern of antimicrobial agents in our study site was satisfactory in hospital indicators but less than optimal in a few prescribing indicators, indicating the need for the root cause analysis for less than optimum results.