PRESCRIBING PATTERNS OF ANTIMICROBIALS IN SURGICAL DEPARTMENTS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

Background: Antimicrobials form an important group of drugs. Increasing prevalence of infections and emergence of resistance to antimicrobials has led to polypharmacy with respect to antimicrobial prescription. Aims and Objectives: To study the prescribing patterns, approval status, adherence to NLEM and WHO-EML and cost of antimicrobials prescribed in surgical departments. Methods: Data was collected from medical records of inpatients that underwent surgical procedures, from SSIMS&RC Teaching Hospital, Davanagere, Karnataka. The antimicrobials were classified based on WHO-ATC classification and analyzed. Results: Among 464 antimicrobials prescribed to 154 patients, 13.79% were prescribed by generic name, 73.28% were prescribed as parenteral preparations and 16 patients received single antimicrobial agent. Mean duration of hospitalization was 10.56 +/- 5.7 days. Beta lactam antimicrobials apart from penicillins (J01D) were the most commonly prescribed. 78.88% of the prescriptions were approved by both DCGI and FDA. 72% of the prescriptions were adhering to the both NLEM and WHO-EML. 72.85% of the prescriptions were single drug formulations. 27.16% were FDCs and 3 of them were not approved either by DCGI or FDA, nor included in any essential medicines list. Conclusion: Among prescriptions analyzed, cefoperazone + sulbactam FDC was not approved by the regulatory bodies nor included in essential medicines list. Majority of antimicrobials were prescribed by brand name. Results indicate that there is a scope for improving prescription pattern which can be facilitated by tailoring the hospital antimicrobial usage guidelines and monitoring the same.