TRENDS IN ANTIMICROBIAL PRESCRIBING: A RETROSPECTIVE ANALYSIS IN A TERTIARY CARE TEACHING HOSPITAL

Objectives: The objective of this study was to assess trends in antimicrobial prescribing pattern in a tertiary care teaching hospital as a foundational step toward establishing an effective antimicrobial stewardship program. Methods: A retrospective observational study was conducted at a tertiary care hospital involving patients admitted to the medicine ward and intensive care unit (ICU) from October to December 2019. Inclusion criteria comprised patients who received at least one antimicrobial agent (AMA). Data were collected from hospital records using a validated data collection tool that had been previously piloted for accuracy. Results: We screened 1066 patients, including 324 (30.4%) patients for whom the rationality of the selection of AMAs was assessed. Only 53.3% of prescriptions were rational, per the hospital antimicrobial policy. Of the total prescriptions, 61.2% of AMAs were prescribed empirically, 31.5% definitively, and 7.3% prophylactically. The range of antibiotics prescribed per patient was 1–4. Although crucial, culture sensitivity testing was performed for 43.3% of ICU patients and 37.9% of medicine ward patients, resulting in an overall testing rate of 38.9% among patients. Conclusion: The implementation of ASP is crucial in combating drug resistance; however, before its implementation, an audit, as conducted here, is essential to identify areas for improvement in antimicrobial prescribing practices. Our findings highlight the need to prioritize culture and sensitivity testing and to ensure adherence to the hospital’s antimicrobial policy through continued education and training for prescribers.