A Study of Unnecessary Use of Antibiotics at a Tertiary care hospital: Urgent need to implement antimicrobial stewardship programs

Background: The resistant bacteria are on upward trend in the third world countries especially in Pakistan. One of the reasons is injudicious prescription of antibiotics. The aim of this study was to estimate the unnecessary use of antibiotics at a tertiary care hospital at Lahore Pakistan. Methods and Material: This is the descriptive, retrospective observational study. A total of 104 persons were recruited from an inpatient department of surgery, medicine and gynaecology in a tertiary care hospital were observed and data collected from June 2014 to July 2014 on the daily basis. The dose and the route of given antibiotics were observed in addition to their baseline tests like CBC (Complete Blood Count), urine complete examination, especially with respect to TLC (Total Leucocyte Count) and pus cells, and if any cultures were done along. Descriptive statistics was applied to data to inference results. Results: A total of 104 persons, consisting of 41% male and 59% female were included in the study. The mean age of total patients were 43.97 +/- 18.3 years. 9.61% patients were not receiving antibiotics. 90% patients received 143(100%) antimicrobials during the period of study with a range of 1-3 antimicrobials per patient. 30% antimicrobials were prescribed unnecessarily without any clinical evidence of infection. The most common prescribed antibiotic was ceftriaxone 30%. It was 88% of the prescription that were prescribed without ordering the culture test. 83 prescriptions were empiric, containing 29% of the unnecessary antibiotics. The unnecessarily prescribed antimicrobials cost 32,865 PKR per day to the sample population. Conclusion: Antimicrobials are being used unnecessarily, even empirical treatment are without significant sound clinical evidence. The antimicrobial resistance and emergence of new mutant strains can be attributable to injudicious use of antibiotics. Antimicrobial stewardship programs should be used to minimize this problem.