A recent government-led study has disclosed a concerning trend in antibiotic usage within 20 tertiary care hospitals, revealing a remarkably high prevalence of 71.9 percent among surveyed patients. Conducted between November 2021 and April 2022, these findings, released by the Union Health Ministry, shed light on the widespread use of antibiotics for both therapeutic (45%) and preventive (55%) purposes.
The report, addressing the pressing issue of antimicrobial resistance (AMR), highlights the indiscriminate and excessive use of antibiotics as a major concern. Despite India’s efforts to combat AMR through various strategies, including surveillance mechanisms to gather antibiotic usage data, the study indicates a lack of comprehensive patient-level information on antibiotic prescription and usage.
Employing the Global Point Prevalence Survey methodology recommended by the World Health Organization (WHO), this study represents a crucial step towards understanding prescribing patterns in hospitals. Out of 11,588 admissions surveyed over six months, 9,652 eligible patients were included, revealing alarming statistics that demand immediate attention and action.
KEY FINDINGS AND RECOMMENDATIONS
The study uncovered a wide variation in antibiotic use across sites, ranging from 37 percent to a staggering 100 percent prevalence. Notably, 86.5 percent of antibiotic prescriptions were administered through the parenteral route, with a significant majority (94%) being empirical therapy rather than definitive treatment.
Of significant concern is the higher prescription rate (57%) of “watch group” antibiotics compared to “access group” antibiotics (38%), as the former poses a greater risk of antibiotic resistance development. The report emphasizes the importance of adhering to standard treatment guidelines, infection control practices, and the development of institution-specific antibiotic policies to encourage the use of lower-resistance potential antibiotics.
The study’s recommendations also stress the need for strict monitoring of reserve group antibiotics’ usage, advocating for their minimal consumption from external pharmacy sources. Furthermore, the report advises against unnecessary polypharmacy, suggesting potential risks associated with adverse effects and drug interactions when combining multiple antibiotics.
URGENT REFORMS AND BEST PRACTICES
To mitigate the rising antibiotic resistance, the study urges institutions to limit surgical prophylaxis to a single dose or one day pre-surgery, with post-procedure infection treatment solely upon confirmed diagnosis. Additionally, institutions are advised to avoid unnecessary double coverage with antibiotics and to closely monitor the usage of drugs not recommended by WHO guidelines.
This comprehensive study on antibiotic usage in tertiary care hospitals emphasizes the critical need for immediate reforms and stringent adherence to standard guidelines. The findings underscore the urgency to curb indiscriminate antibiotic use, safeguarding against the looming threat of antimicrobial resistance for the collective well-being of patients and public health.
