Najmi Ahmad, Sadasivam Balakrishnan, Jhaj Ratinder, Atal Shubham, Kumar Sunil, Santenna C
Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
J Family Med Prim Care. 2019 Jul;8(7):2212-2217. doi: 10.4103/jfmpc.jfmpc_430_19.
To evaluate the point prevalence of antimicrobial drug use by using point prevalence survey method.
A cross-sectional point prevalence study was done on patients admitted in AIIMS Bhopal hospital. This study included all inpatients receiving an antimicrobial that were on the ward at 8 AM on a specific day in May 2018. Information regarding age, gender, occupation, income group, diagnosis, patient's present/past medical history, treatment, any adverse drug reactions, and investigations are recorded in a pro forma.
A total of 77 patients (31.95%) were included out of total 241 patients who received at least one antimicrobial. Of patients who received at least one antimicrobial, diagnosis was mentioned in 83.11% of prescriptions. Targeted treatment was given to 10.38% of patients. Reasons for antimicrobial were recorded in 12.98% of patients. Most common healthcare infection recorded was catheter-associated urinary tract infections followed by postoperative surgical site infections. Penicillin with beta lactamase inhibitors was most commonly prescribed antibiotic group followed by third generation cephalosporins and fluoroquinolones. Stop or review date was recorded in 19.48% of patients. Parenteral administration was given to 30.55% of patients. Compliance to guidelines was followed in 64.11% of patients. Local antibiotic guideline and antibiogram were available in hospital. Biomarkers were utilized in 9.77% of patients to guide the choice of therapy.
Availability of antibiotic policy, antibiogram, local antibiotic guidelines, drugs, and therapeutic committee were some of the encouraging findings. Diagnosis was mentioned in majority of prescriptions. Most patients were prescribed oral antimicrobial drugs, which can reduce complications with parenteral route. Underutilizations of microbiological facilities, prolonged use of antibiotics for surgical prophylaxis, and polypharmacy were areas of concern.
采用现患率调查方法评估抗菌药物的使用现患率。
对在博帕尔全印医学科学研究所医院住院的患者进行了一项横断面现患率研究。本研究纳入了2018年5月某一特定日期上午8点在病房接受抗菌药物治疗的所有住院患者。有关年龄、性别、职业、收入群体、诊断、患者目前/过去的病史、治疗、任何药物不良反应以及检查的信息记录在一份表格中。
在总共241名至少接受过一种抗菌药物治疗的患者中，共纳入77名患者（31.95%）。在至少接受过一种抗菌药物治疗的患者中，83.11%的处方中提到了诊断。10.38%的患者接受了针对性治疗。12.98%的患者记录了使用抗菌药物的原因。记录到的最常见的医院感染是导管相关尿路感染，其次是术后手术部位感染。最常开具的抗生素组是青霉素与β-内酰胺酶抑制剂，其次是第三代头孢菌素和氟喹诺酮类。19.48%的患者记录了停药或复查日期。30.55%的患者接受了胃肠外给药。64.11%的患者遵循了指南。医院有当地抗生素指南和抗菌谱。9.77%的患者利用生物标志物来指导治疗选择。
抗生素政策、抗菌谱、当地抗生素指南、药物以及治疗委员会的存在是一些令人鼓舞的发现。大多数处方中提到了诊断。大多数患者开具的是口服抗菌药物，这可以减少胃肠外给药途径的并发症。微生物学设施利用不足、手术预防性抗生素的长期使用以及联合用药是令人担忧的领域。
